title: Adhesive intestinal obstruction in infants and children: the place of conservative treatment.
abstract: Objectives. Adhesive intestinal obstruction (AIO) is rare in the pediatric age group and its treatment is still controversial. This is a retrospective review of our experience in infants and children with AIO. Patients and Methods. The records of infants and children with AIO between January 2001 and December 2010 were retrospectively reviewed for age at diagnosis, sex, initial operation, interval between initial operation and presentation, diagnosis, treatment and outcome. Results. 44 infants and children were admitted with AIO. There were 28 males and 16 females who had 46 episodes. Their ages at presentation ranged from 1 month to 12 years (mean 5.4 years), while their ages at initial operation ranged from 2 days to 12 years (mean 4.15 years). Time elapsed from initial operation to presentation ranged from 7 days to 8 years (mean 1.5 years), and 66% developed AIO within 1 year from initial operation. Appenedecectomy was the commonest operation (29.5%). Four (9%) responded to conservative treatment. The other 40 (91%) required surgical intervention. Twenty-nine had release of adhesions only, while 10 (25%) had resection of small intestines and one underwent stricturoplasty. Two developed recurrence and one died. Conclusions. AIO is rare in the pediatric age group and the majority becomes symptomatic within 1 year of operation. Appendecectomy is the commonest operation leading to AIO. The place of conservative treatment is limited and to obviate delay and decrease the chance of intestinal ischemia, they should be treated early with surgical adhesiolysis.
authors.affiliation: Department of Pediatric Surgery, Maternity and Children Hospital, P.O. Box 61015, Dammam, Qatif 31911, Saudi Arabia.
authors.forename: Ahmed H
authors.initials: AH
authors.lastname: Al-Salem
authors.forename: Mohammad
authors.initials: M
authors.lastname: Oquaish
references.citation: Ann Surg. 1982 Nov;196(5):580-3
references.pmid: 7125744
references.citation: N Z Med J. 1999 Nov 12;112(1099):421-3
references.pmid: 10678224
references.citation: Surg Endosc. 1999 Sep;13(9):925-7
references.pmid: 10449855
references.citation: J Pediatr Surg. 1981 Jun;16(3):225-35
references.pmid: 7252724
references.citation: J Pediatr Surg. 1991 Jan;26(1):37-41
references.pmid: 2005522
references.citation: Eur J Pediatr Surg. 1997 Feb;7(1):13-5
references.pmid: 9085802
references.citation: Br J Surg. 1986 Sep;73(9):762-4
references.pmid: 3756446
references.citation: Med J Malaysia. 2005 Mar;60(1):81-4
references.pmid: 16250285