DIAGNOSIS AND TREATMENT OF ACUTE ADHESIVE INTESTINAL
OBSTRUCTION IN CHILDREN
Cao W-G, Zhang J-Z
Beijing Children's
hospital, Beijing, China
Objective: To discuss the cause,
diagnosis and treatment of intestinal obstruction due to adhesions.
Methods: Reviewing 168 cases with
admission diagnosed as intestinal obstruction due to adhesions from
January, 1996 to December, 2000, the previous operations on abdomen and
peritoneal infection, the symptoms, signs, x-ray findings, operative and
postoperative records were studied.
Results: The operative rate
following postoperative adhesions was higher than that following peritoneal
infection(P<0.001)。Intestinal obstructions
following midline incision were more than that following peripheral
incision(P<0.001)。Of 168 cases, 89 cases
were operated on with an average hospital stay for 2 weeks, 30 cases
without intestinal obstruction were done according to the symptoms with a
hospital stay for one week(P<0.001)。It was important to
relieve obstructive site adequately during operation. Barium meal
examination was used in intestinal obstruction with massive adhesions.
Barium enema examination usually was used to determine the completeness of
obstruction.
Conclusion: When patients with a
history of abdominal operation or peritoneal infection come for treatment
of adhesive intestinal obstruction, it is important to determine the
diagnosis of obstruction or no obstruction, and then, to determine partial
or complete obstruction. Barium enema and barium meal examination is useful
diagnostic tools in cases of uncertainty. For complete obstruction
operation are successfully carried out when obstructive site is found and
relieved. For partial obstructions, passing out of barium meal will confirm
the cure without operation.