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Adhesive Intestinal Obstruction in Infants and Children: The Place of Conservative Treatment

机译:婴幼儿粘连性肠梗阻:保守治疗的地方

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摘要

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.
机译:目标。粘连性肠梗阻(AIO)在小儿年龄段很少见,其治疗仍存在争议。这是对我们在AIO婴儿和儿童中的经验的回顾性回顾。患者和方法。回顾性地回顾了2001年1月至2010年12月的婴儿和儿童AIO的记录,包括诊断年龄,性别,初次手术,初次手术与就诊之间的间隔,诊断,治疗和结局。结果。 AIO收治了44名婴儿和儿童。男28例,女16例,发作46例。他们的陈述年龄为1个月至12岁(平均5.4岁),而初次手术的年龄则为2天至12岁(平均4.15岁)。从首次手术到演示的时间从7天到8年不等(平均1.5年),并且有66%的患者在首次手术后1年内发展了AIO。阑尾切除术是最常见的手术(29.5%)。四个(9%)对保守治疗有反应。其他40名(91%)需要手术干预。二十九例仅释放粘连,而十例(25%)切除了小肠,其中一例接受了严格的尿囊成形术。 2例复发,1例死亡。结论。 AIO在儿童年龄组中很少见,大多数在手术后1年内即出现症状。阑尾切除术是导致AIO的最常见手术。保守治疗的位置是有限的,并且为了避免延迟和减少肠缺血的机会,应及早通过外科手术进行粘膜溶解治疗。

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