Bowel obstruction without history of laparotomy: Clinical analysis of 70 patients

Yoshimaru, Koichiro; Kinoshita, Yoshiaki; Matsuura, Toshiharu; Esumi, Genshiro; Wada, Mariko; Takahashi, Yoshiaki; Yanagi, Yusuke; Hayashida, Miyeko; Ieiri, Satoshi; Taguchi, Tomoaki

doi:10.1111/ped.13003

Cited by 12 publications

(8 citation statements)

References 17 publications

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“…Intussusception is one of the most common causes of intestinal obstruction in children [1,2]. The diagnosis is usually confirmed by ultrasound, which has 98-100% sensitivity and 88% specificity [3].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Failure of Pneumatic Reduction in Children with Ileocolic Intussusception

Younes

Lee

et al. 2021

Children

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Intussusception is one of the most common causes of intestinal obstruction in children. Pneumatic reduction is the treatment of choice and has a high success rate. The most common cause of pneumatic reduction failure is the presence of a pathological leading point. We aimed to identify other factors that can lead to pneumatic reduction failure in children with ileocolic intussusception. This was a retrospective study conducted in two centers. Data were collected from January 2013 to December 2014. A total of 156 patients were diagnosed with intussusception and underwent pneumatic reduction, with the exception of one patient with peritonitis. We included patients with ileocolic-type intussusception without apparent pathological leading points. Logistic regression analysis of clinical parameters was performed to identify factors associated with pneumatic reduction failure. Of 156 patients diagnosed with intussusception in both hospitals, 145 were enrolled in the study. The overall efficacy of pneumatic reduction was 85.7%, and surgical reduction was performed in 21 patients. Univariate analysis showed that a high segmented neutrophil count, low hemoglobin level, high body temperature, and higher weight percentile were associated with pneumatic reduction failure. Multivariate analysis showed that a high segmented neutrophil count, low hemoglobin level, and higher weight percentile were significantly associated with pneumatic reduction failure. Pneumatic reduction is safe and effective as a first-line treatment for pediatric intussusception. However, a high segmented neutrophil count, low hemoglobin level, and higher weight percentile are associated with the failure of this treatment.

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Section: Introductionmentioning

confidence: 99%

Factors Associated with Failure of Pneumatic Reduction in Children with Ileocolic Intussusception

Younes

Lee

et al. 2021

Children

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“…Intussusception can lead to strangulation, which can cause bowel ischemia and necrosis due to blood flow blockage. The operation for intussusception is highly important to avoid intestinal ischemia and necrosis because a delayed response might lead to unnecessary bowel resection, sepsis, and even death [ 11 , 12 ]. All these are serious complications following bowel ischemia and necrosis due to intussusception.…”

Section: Discussionmentioning

confidence: 99%

A promising new predictive factor for detecting bowel resection in childhood intussusception: the lymphocyte-C-reactive protein ratio

et al. 2021

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Background The most critical concern for the management of childhood intussusception is bowel resection due to intestinal ischemia and necrosis. The early prediction of this problem is of great importance. We investigated the value of various combinations of inflammatory factors to predict intestinal necrosis and resection. Methods We retrospectively reviewed the medical records of pediatric patients with intussusception who underwent surgical management. During the research period, 47 patients who underwent intestinal resection due to intestinal necrosis and 68 patients who did not undergo intestinal resection were enrolled. We evaluated the diagnostic value of various combinations of inflammatory markers from preoperative laboratory analyses using the receiver operating characteristic (ROC) method. Results In the current cohort, 115 patients underwent operations for intussusception; among them, 47 patients (40.9%) underwent intestinal resections. In the patients with intestinal resection, the neutrophil count(p = 0.013), CRP level(p = 0.002), platelet–lymphocyte ratio (PLR, p = 0.008), NLR (neutrophil–lymphocyte ratio, p = 0.026), and LCR (lymphocyte–CRP ratio, p < 0.001) values were significantly higher than those in the patients without any resection. The receiver operating characteristic (ROC) analysis results showed that the combination of lymphocytic count along with C-reactive protein levels (LCR) demonstrated the highest correlation with intestinal resection due to intussusception compared with other parameters in the patients, with a sensitivity of 0.82 (0.73–0.86) and specificity of 0.80 (0.57–0.94) for the diagnosis of strangulation. Conclusion The preoperative LCR level is a useful marker to predict the need for intestinal resection due to intestinal necrosis in patients with intussusception.

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“…The intussusception can become strangulated, which can cause bowel ischemia and necrosis due to the blood ow blocking. The operation is highly important to avoid the intestinal ischemia and necrosis in intussusception, because a delayed response might cause unnecessary bowel resection, sepsis, and even death [11,12], all these were serious complications following bowel ischemia and necrosis due to intussusception. The primary rationale for early operative intervention is to avoid bowel resection due to ischemia [13].…”

Section: Discussionmentioning

confidence: 99%

A Promising New Predictive Factor for Detecting Bowel Resection in Childhood Intussusception: Lymphocyte-C Reactive Protein Ratio

Chen

Cao

Yan

et al. 2021

Preprint

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Background: The most critical concern for management of childhood intussusception is the bowel resection due to the intestinal ischemia and necrocis. It is of great importance for early prediction of this problem. We investigate the value of various combinations of inflammatory factors to predict the intestinal necrocis and resection.Methods: We retrospectively reviewed the medical records of pediatric patients with intussusception, which undergone surgical management. During the research period, 47 patients undergone intestinal resection due to intestinal necrocis and 68 patients without intestinal resection were enrolled. We evaluated the diagnostic values of various combination of inflammatory markers from preoperative period laboratory analyses using the receiver operating characteristic (ROC) method.Results: In the current cohort, 115 patients were operated for intussusception, among them, 47 patients (40.9%) undergone intestinal resections. In patients with intestinal resections, neutrophil count(p=0.013), CRP(p=0.002), platelet–lymphocyte ratio(PLR, p=0.008), NLR(neutrophil–lymphocyte ratio, p=0.026), and LCR(lymphocyte–CRP ratio, p<0.001) values were significantly higher than those in the patients without any resections. Receiver operating characteristic (ROC) analysis results showed that the combination of lymphocytic count along with C-reactive protein levels (LCR) demonstrated the highest correlation with intestinal resection due to intussusception compared with other parameters in patients, with sensitivity of 0.82(0.73–0.86) and specifficity of 0.80(0.57–0.94) for the diagnosis of strangulation. Conclusion: The preoperative LCR level is a useful marker to predict the need for intestinal resection due to intestinal necrosis in patients with intussusception.

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Bowel obstruction without history of laparotomy: Clinical analysis of 70 patients

Cited by 12 publications

References 17 publications

Factors Associated with Failure of Pneumatic Reduction in Children with Ileocolic Intussusception

Factors Associated with Failure of Pneumatic Reduction in Children with Ileocolic Intussusception

A promising new predictive factor for detecting bowel resection in childhood intussusception: the lymphocyte-C-reactive protein ratio

A Promising New Predictive Factor for Detecting Bowel Resection in Childhood Intussusception: Lymphocyte-C Reactive Protein Ratio

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