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Small bowel obstruction in children: review of 10 years experience
H Ikeda1, S Matsuyama, N Suzuki
1Department of Surgery, Gunma Children's Hospital Medical Center, Japan.
Insights
Intussusception is the primary cause of small bowel obstruction in children over one month old. Early diagnosis using ultrasonography is crucial for effective treatment of pediatric bowel obstruction.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Small bowel obstruction is a common surgical emergency in children.
- Excluding postoperative adhesive ileus, various intrinsic and extrinsic factors can cause pediatric small bowel obstruction.
Purpose of the Study:
- To review the causes and diagnostic methods of small bowel obstruction in pediatric patients.
- To evaluate the efficacy of ultrasonography in diagnosing pediatric small bowel obstruction.
Main Methods:
- Retrospective review of 32 patients (1 month to 6 years) treated between June 1982 and May 1992.
- Analysis of causative lesions, age distribution, and diagnostic modalities.
Main Results:
- Intussusception was the most frequent cause (53.1%), followed by incarcerated inguinal hernia (18.8%) and mesenteric cysts (9.4%).
- Ileal duplication cysts and Meckel's diverticulum were identified as causative lesions.
- Ultrasonography demonstrated utility in differential diagnosis.
Conclusions:
- Intussusception is the leading cause of non-adhesive small bowel obstruction in this pediatric cohort.
- Ultrasonography should be routinely employed for diagnosing small bowel obstruction in children due to its diagnostic value.
Abstract:
Small bowel obstruction, excluding postoperative adhesive ileus, in patients > 1 month old treated between June 1982 and May 1992 at Gunma Children's Hospital Medical Center is reviewed. There were 32 patients, 22 boys and 10 girls, whose ages ranged from 1 month to 6 years (median 9 months). Intussusception was the most frequent cause of obstruction and was seen in 17 patients (53.1%). Causative lesions were identified in five patients, and were ileal duplication cysts in four and Meckel's diverticulum in one. Incarcerated inguinal hernia and mesenteric cysts resulted in bowel obstruction in six and three patients, respectively. Other causes included mesodiverticular band, ileal volvulus without malrotation, abnormal adhesion of omentum, abnormal band, vitelline duct remnant and trapping in a mesenteric defect. As for the age distribution, there was no significant correlation between the causes of obstruction and the age of patients. Ultrasonography was useful in differential diagnosis, and this modality should therefore be used in every patient with signs of small bowel obstruction.