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Hyperbaric oxygen therapy for intestinal obstruction in children: an exceptional experience in a compromised child
1Department of Surgery II, Nagasaki University School of Medicine, Japan.
Insights
Hyperbaric oxygen therapy successfully treated intestinal obstruction in a pediatric patient with yolk sac carcinoma undergoing chemotherapy. This approach offers a viable alternative when surgery is not possible.
Area of Science:
- Pediatric Oncology
- Gastroenterology
- Hyperbaric Medicine
Background:
- A 2-year-old girl with retroperitoneal yolk sac carcinoma developed intestinal obstruction during chemotherapy.
- Chemotherapy-induced myelosuppression precluded surgical intervention for the obstruction.
Observation:
- Nonoperative management was ineffective for the intestinal obstruction.
- Hyperbaric oxygen therapy (HBOT) was administered twice at 2.8 atm for 111 minutes.
Findings:
- The patient's general condition improved significantly post-HBOT.
- Radiographic evidence of obstruction resolved, with no adverse effects noted.
- Subsequent tumor resection was successful; intestinal resection was avoided.
Implications:
- HBOT is a potential adjunctive therapy for pediatric intestinal obstruction when operative intervention is contraindicated.
- This case represents the first use of HBOT for pediatric intestinal obstruction.
- HBOT may improve outcomes in critically ill pediatric cancer patients with gastrointestinal complications.
Abstract:
Intestinal obstruction in a 2-year-old girl with a histologically proven diagnosis of retroperitoneal yolk sac carcinoma developed after the second course of anticancer chemotherapy. Nonoperative treatment was not effective. Because the patient had fallen into a state of chemotherapy-induced myelosuppression, surgery was ruled out. Thus, hyperbaric oxygen therapy was the next treatment of choice. It was performed twice under hyperbaric oxygen conditions at 2.8 atmospheric pressure for 111 minutes. After the procedure, her general status recovered well. The air-fluid level disappeared on the radiograph, and no adverse effects were observed. Later, a surgical removal of the primary tumor was performed successfully, but an intestinal resection was not required. This is the first instance in which we performed hyperbaric oxygen therapy on a child in the management of an intestinal obstruction. Based on the successful outcome in this case, hyperbaric oxygen therapy is suggested to be a useful adjunct to nonoperative therapy for intestinal obstruction when a patient's overall state does not allow operative intervention.