Is nonoperative management of adhesive intestinal obstruction applicable to children in a resource-poor country?

Abstract

Nonoperative management was unsuccessful in this setting. Open adhesiolysis may be adopted in children to prevent avoidable morbidities and mortalities in settings with limited resources.

Is non-operative management still justified in the treatment of adhesive small bowel obstruction in children?

“…[10] Al-Salem et al also reported that 40 (91%) of 44 children required laparotomy in their series. [13] In both publications, the authors advocated surgical adhesiolysis in children with ASBO.…”

“…[10,13] Such assertions have been refuted with the reporting of successful non-operative management. However, the optimal management of ASBO in the pediatric population is continuously debated in literature and served as an impetus for the current study.…”

“…The reported success of non-operative management varies widely from 0% to 63%. [8,[10][11][12] The relatively high rate of operation may partially reflect unease with protracted trials of conservative management among pediatric surgeons.…”

Adhesive Intestinal Obstruction as One of the Causes of Emergency Conditiond in Children

“…Остальным необходимо проводить динамическое рентгенокон-трастное исследование -пассаж бария по кишечнику [10,15,21]. Малоинформативность обзорной рентгено-графии, особенно на ранней стадии заболевания, обу-словлена тем, что нет еще четкого перераспределения жидкости и газов в кишечнике, дающего классические рентгенологические признаки (арки и чаши Клойбера) [10,28,29].…”

“…Послеоперационный период характеризуется не только меньшим болевым синдромом, быстро восста-навливающейся перистальтикой кишечника и активно-стью ребенка, но и отсутствием осложнений со стороны послеоперационных ран, хорошими косметическими результатами, сокращением сроков госпитализации, а следовательно, улучшением качества жизни пациен-тов [29,41].…”