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Strangulated small bowel obstruction in children.

Abstract：

BACKGROUND:Diagnosing intestinal strangulation as a complication of small bowel obstruction (SBO) remains a considerable challenge in children. We evaluated the clinicoradiological parameters for predicting the presence of a strangulated intestine. METHODS:We reviewed the medical records of 69 pediatric patients who underwent operation for acute SBO. Regression analysis was used to identify the parameters for predicting strangulated SBO. RESULTS:Of the 69 patients with SBO, 27 patients had intestinal strangulation and were awarded one point each towards the overall clinical score: intractable continuous abdominal pain, tachycardia, white blood cell count >13,600/mm3, and abdominal distention. Patients with a clinical score ≥2 combined with the presence of ascites in ultrasound (US) results or with wall thickness and reduced wall contrast enhancement in abdominal computed tomography (CT) scans showed strong evidence for intestinal strangulation. CONCLUSION:The combination of two or more clinical parameters, including intractable continuous abdominal pain, tachycardia, leukocytosis, and abdominal distention with the presence of ascites in US or wall thickness and reduced wall contrast enhancement in, is useful for the identification of strangulated SBO. THE TYPE OF STUDY AND LEVEL OF EVIDENCE:Prognosis study; Level III.

journal_name

J Pediatr Surg

journal_title

Journal of pediatric surgery

authors

Chang YJ,Yan DC,Lai JY,Chao HC,Chen CL,Chen SY,Tsai MH

doi

10.1016/j.jpedsurg.2017.03.002

subject

Has Abstract

pub_date

2017-08-01 00:00:00

pages

1313-1317

issue

8

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(17)30148-3

journal_volume

52

pub_type

杂志文章

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