Diagnostic value of clinical investigation of children with adhesive intestinal obstruction

Authors

DOI:

https://doi.org/10.15574/PS.2022.76.52

Keywords:

children, diagnosis, clinical investigations, adhesive intestinal obstruction

Abstract

Early diagnosis and objective determination of the presence and degree of intestinal obstruction is important for practicing surgeons. The abdominal X-ray examination, the contrast passage examination, and in some cases computer tomography are used for clinical confirmation of this pathological condition.

The purpose - to reveal the diagnostic value of clinical investigation methods in children with adhesive intestinal obstruction.

Materials and methods. We followed up 89 children with adhesive intestinal obstruction. All the children, in addition to a complete clinical physical examination during hospitalization, had the clinical investigation in order to verify the diagnosis: X-ray examination and ultrasound examination of the abdominal organs.

Results. According to our data, the main signs of intestinal obstruction at the X-ray examination of the abdominal cavity were the absence of gas in the large intestine (66; 74.2%), hydroaeric levels or Kloiber’s cups (58; 65.2%) and dilation of small intestine loops ≥3 cm (37; 41.6%); at the ultrasound of the abdominal organs - dilation of the small intestine loops ≥3 cm (70; 78.7%) and an ineffective peristalsis (33; 37.1%).

Conclusions. Rapid diagnosis of the surgical disaster in children with suspected adhesive intestinal obstruction and important information is provided by X-ray examination and ultrasound examination of abdominal organs. Ultrasound diagnosis of abdominal organs in patients with peritoneal adhesions is non-invasive and sufficiently informative for multiple monitoring of the disease and the effectiveness of treatment without negative impact on the patient.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of all the institutions mentioned in the work. Informed consent was obtained from parents (or guardians).

No conflict of interests was declared by the authors.

References

Almafreji I, Chinaka U, Hussain A, Lynch, M, Cottrell R. (2020). Role of Gastrografin in Patients With Small Bowel Obstruction. Cureus. 12 (8): e9695. https://doi.org/10.7759/cureus.9695

Bonnard A, Kohaut J, Sieurin A, Belarbi N, El Ghoneimi A. (2011). Gastrografin for uncomplicated adhesive small bowel obstruction in children. Pediatr Surg Int. 27 (12): 127-181. https://doi.org/10.1007/s00383-011-2963-8; PMid:21818521

Deng Y, Wang Y, Guo C. (2019, Mar). Prediction of surgical management for operated adhesive postoperative small bowel obstruction in a pediatric population. Medicine (Baltimore). 98 (11): e14919. https://doi.org/10.1097/MD.0000000000014919; PMid:30882714 PMCid:PMC6426593

Gerner-Rasmussen J, Donatsky AM, Bjerrum F. (2019). The role of non-invasive imaging techniques in detecting intra-abdominal adhesions: a systematic review. Langenbecks Arch Surg. 404 (6): 653-661. https://doi.org/10.1007/s00423-018-1732-8; PMid:30483880

Khan RA, Ara R, Wahab Sh, Ahmad I. (2019). Ultrasound in pediatric intestinal obstruction: Assessing its full potential. Paediatric Surgery. Ukraine. 4 (65): 19-24. https://doi.org/10.15574/PS.2019.65.19

Kvashnina AA, Melnychenko MG, Rybalchenko VF. (2022). Clinical effectiveness of sodium hyaluronate gel usage for prevention of postoperative adhesion in children. Modern Pediatrics. Ukraine. 2 (122): 21-26. https://doi.org/10.15574/SP.2022.122.21

Melnichenko M, Kvashnina A. (2020). Pathogenetic aspects of post-surgical adhesions prevention (review of literature). J Educ Health Sport. 10 (5): 380-393. https://doi.org/10.12775/JEHS.2020.10.05.040

MOZ Ukrainy. (2012). Pro zatverdzhennia protokoliv likuvannia ditei zi spetsialnosti «Dytiacha khirurhiia» iz zminamy vnesenymy nakazom Ministerstva okhorony zdorov'ia Ukrainy. Nakaz MOZ Ukrainy No 150.

Paily A, Kotecha J, Sreedharan L, Kumar B. (2019). Resolution of adhesive small bowel obstruction with a protocol based on Gastrografin administration. Med Life. 12 (1): 10-14. https://doi.org/10.25122/jml-2018-0082; PMid:31123519 PMCid:PMC6527405

Smereczyński A, Starzyńska T, Kołaczyk K, Bojko S et al. (2012). Intra-abdominal adhesions in ultrasound. Part I: The visceroperitoneal bordeline, anatomy and the method of examination. J Ultrason. 12 (51): 472-478. https://doi.org/10.15557/JoU.2012.0034; PMid:26674107 PMCid:PMC4603241

Smereczyński A, Starzyńska T, Kołaczyk K, Bojko S et al. (2013). Intra-abdominal adhesions in ultrasound. Part II: The morphology of changes. J Ultrason. 13 (52): 93-103. https://doi.org/10.15557/JoU.2013.0008; PMid:26675524 PMCid:PMC4613568

Ten Broek R, Krielen P, Di Saverio S, Coccolini F et al. (2018, Jun 19). Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group. World J Emerg Surg. 13: 24. https://doi.org/10.1186/s13017-018-0185-2; PMid:29946347 PMCid:PMC6006983

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Published

2022-09-30

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Original articles. Abdominal surgery