Diagnostic value of clinical investigation of children with adhesive intestinal obstruction

Abstract

Early diagnosis and objective determination of the presence and degree of intestinal obstruction is important for practicing surgeons. The abdominal X-ray examination, the contrast passage examination, and in some cases computer tomography are used for clinical confirmation of this pathological condition. The purpose - to reveal the diagnostic value of clinical investigation methods in children with adhesive intestinal obstruction. Materials and methods. We followed up 89 children with adhesive intestinal obstruction. All the children, in addition to a complete clinical physical examination during hospitalization, had the clinical investigation in order to verify the diagnosis: X-ray examination and ultrasound examination of the abdominal organs. Results. According to our data, the main signs of intestinal obstruction at the X-ray examination of the abdominal cavity were the absence of gas in the large intestine (66; 74.2%), hydroaeric levels or Kloiber’s cups (58; 65.2%) and dilation of small intestine loops ≥3 cm (37; 41.6%); at the ultrasound of the abdominal organs - dilation of the small intestine loops ≥3 cm (70; 78.7%) and an ineffective peristalsis (33; 37.1%). Conclusions. Rapid diagnosis of the surgical disaster in children with suspected adhesive intestinal obstruction and important information is provided by X-ray examination and ultrasound examination of abdominal organs. Ultrasound diagnosis of abdominal organs in patients with peritoneal adhesions is non-invasive and sufficiently informative for multiple monitoring of the disease and the effectiveness of treatment without negative impact on the patient. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of all the institutions mentioned in the work. Informed consent was obtained from parents (or guardians). No conflict of interests was declared by the authors.