Small bowel obstruction due to adhesions following neonatal laparotomy

Abstract

The aim of this study was to assess the incidence of small bowel obstruction (SBO) due to adhesions following laparotomy in the neonatal period. This was a retrospective study of babies born between January 1998 and November 2003 who had a trans-abdominal procedure in the neonatal period in the John Radcliffe Hospital, Oxford, UK. Four hundred and fourteen patients had a trans-abdominal procedure during this period. The follow-up period ranged from 2 months to 6 years (median 39 months). Overall, twenty-three patients (6%) underwent subsequent laparotomy for SBO due to adhesions. Four patients (17%) who developed SBO due to adhesions had another adhesive obstruction requiring a further laparotomy. The majority of adhesions occurred within a year of the original procedure (87%). A single band caused the obstruction in eight patients (35%), multiple adhesions in six (26%), and dense adhesions in nine patients (39%). The incidence of SBO was highest following surgery for meconium ileus, followed by necrotizing enterocolitis (NEC), and malrotation. There were no deaths due to small bowel obstruction in this study.

The long-term follow-up of patients with a congenital diaphragmatic hernia: a broad spectrum of morbidity

“…The most commonly performed second surgical intervention in CDH is reexploration for small bowel obstruction [32,110]. This percentage is considerably higher than those of postoperative intestinal obstruction in other patients who had laparotomy in the neonatal period, infancy and childhood (2.2-6%) and in patients who had Ladd's procedure for malrotation (8.3%) [111][112][113], but comparable to patients operated for gastroschisis or omphalocele [114]. Several mechanisms may contribute to the increased susceptibility to intestinal obstruction among patients with diaphragmatic defects.…”

The Advantages of Minimally Invasive Surgery for Peritoneal Adhesions in Children

“…По разным данным, послеоперационные состояния у детей осложняются СКН в 1,1-6% случаев [2,3], другими видами кишечной непрохо-димости -в 30-40%: до 60% всех релапаротомий выпол-няется по поводу острой СКН, из них до 90% -в первый год после хирургического лечения основного заболевания. У детей до 3 лет жизни острая СКН развивается редко [4].…”

Experience in Management of Adhesive Bowel Obstruction

“…Распро-стра ненность этой формы патологии у детей, в анамнезе которых были оперативные вмешательства, составляет от 1,1 до 6% [1][2][3]. До 40% случаев кишечной непрохо-димости обусловлено именно острой СКН.…”

“…До 40% случаев кишечной непрохо-димости обусловлено именно острой СКН. Она является причиной до 60% повторных лапаротомий, 90% из кото-рых выполняются в первый год после предыдущих опе-ративных вмешательств [1,2,4].…”