title: Conservative treatment of adhesive small bowel obstruction in children: a systematic review.
abstract: OBJECTIVE
  To assess the effectiveness of conservative treatment for adhesive small bowel obstruction (ASBO) in children.
  
  
  METHODS
  Systematic review of studies involved children with ASBO who received initial conservative/non-operative treatment.
  
  
  METHODS
  The search was performed in April 2013 using PubMed (see online supplementary file 1), current contents, and the Cochrane database.
  
  
  METHODS
  Children with ASBO.
  
  
  METHODS
  Conservative treatment included nasogastric decompression, parenteral fluids and correction of electrolyte and fluid imbalance.
  
  
  METHODS
  Treatment success.
  
  
  RESULTS
  Length of hospital stay and the time to first feeding after hospital admission.
  
  
  RESULTS
  7 studies (six retrospective, one prospective), involving 8-109 patients (age: 1 month to 16 years) treated conservatively, were included in the review. The nature of conservative treatment was generally consistent between studies (nasogastric decompression, parenteral fluids and correction of electrolyte and fluid imbalance), although patients in one study also received Gastrografin. The rate of conservative treatment success ranged from 16% to 75% among the five studies, but one trial showed 0% successful rate. The hospital length of stay ranged from 3 to 6.5 days for conservative treatment (vs 10.2-13 days for operative treatment). The time to first feeding ranged from 31 to 84 h for conservative treatment.
  
  
  CONCLUSIONS
  In conclusion, in the majority of cases, conservative treatment is an effective means of managing ASBO in children.
authors.affiliation: Departments of Pediatrics, Cathay General Hospital, Taipei, Taiwan School of Medicine, FuJen Catholic University, New Taipei City, Taiwan.
authors.forename: Lung-Huang
authors.initials: LH
authors.lastname: Lin
authors.affiliation: Departments of Pediatrics, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Chee-Yew
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Song-Shan Armed Forces General Hospital, Taipei, Taiwan.
authors.forename: Min-Hsuan
authors.initials: MH
authors.lastname: Hung
authors.affiliation: Department of Surgery, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Der-Fang
authors.initials: DF
authors.lastname: Chen
mesh_terms: D002648:Child; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications; D007415:Intestinal Obstruction / Q000209:etiology / Q000628:therapy*; D000267:Tissue Adhesions / Q000150:complications
keywords: QUALITATIVE RESEARCH