Intestinal obstruction Latest Topics

Management of adhesive small bowel obstruction in pediatric

Sat, 18 Jan 2025 18:44:58 +0000

This quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns -

"Review of the KID data found a 1.67 odds ratio of small bowel resection with operative intervention delayed until hospital day 3–14, and no difference in small bowel resection between operating on day 1 versus day 2. It is recommended that stable patients without concerning signs of perforation, strangulation, or peritonitis can be safely managed conservatively for 48 h in children over 2 years and 24–48 h in children less than 2 years of age [18]. It is crucial that these patients are closely observed for signs of deterioration in either their physiology or abdominal exam and receive prompt operative management at recognition of these changes. If patients do not improve over the observation period, it is recommended that they also receive operative intervention [18]."

water-soluble contrast challenge in pediatric adhesive small bowel obstruction

Sun, 26 May 2024 11:00:24 +0000

26/11/2023

Sun, 26 Nov 2023 11:40:34 +0000

[size=20px]A 14-year-old girl with a history of multiple abdominal operations presents with nausea, vomiting, abdominal pain, distention and obstipation. She is hemodynamically stable and has received intravenous fluids. A nasogastric tube has been placed. Her abdominal x-ray demonstrates dilated loops of small bowel. The best next step in management is:

A admission for serial abdominal exams and imaging

B laparotomy

C laparoscopic exploration

D contrast challenge via the NG tube

E contrast enema[/size]

29/10/2023

Sun, 29 Oct 2023 10:49:44 +0000

[size=20px]A 10 year old boy with a history of ileal atresia repair as an infant presents to the emergency department with a 2 day history of abdominal pain and emesis. The child was well prior to the onset of symptoms. He has not had fever or sick contacts. He does not report ever having similar symptoms. Plain abdominal x-rays reveal concern for a partial small bowel obstruction. Which of the following may decrease this child length of stay and need for operative intervention?

A Gastrografin challenge

B Barium enema

C Early enteral feeding

D Avoidance of nasogastric decompression

E CT scan with IV contrast

[/size]

2/7/2023

Sun, 02 Jul 2023 10:55:26 +0000

A 13- year-old boy with history of staged closure of gastroschisis as an infant presents with abdominal distention, bilious vomiting, and abdominal pain. Abdominal Xray is shown below. A representative image of the CT is shown below. It is interpreted as small bowel obstruction (SBO). Which of the following is a clinical or radiologic finding that would be a contraindication to contrast challenge in this patient?

[center]

[/center]

[size=20px]A High grade bowel obstruction

B Closed loop bowel obstruction

C SBO three years ago requiring adhesiolysis

D SBO 6 months ago managed by contrast challenge

E Bilious vomiting[/size]

laparoscopic adhesiolysis

Mon, 22 Nov 2021 16:34:55 +0000

see video link in second post

volvulus short term and long term problems!

Sat, 27 Aug 2022 07:11:22 +0000

21/8/2022

Sun, 21 Aug 2022 13:01:53 +0000

[size=20px]A sixteen-year old presents with chronic abdominal complaints. Which of the following is true regarding intestinal malrotation diagnosed beyond infancy?

A most patients can expect resolution of symptoms with Ladd procedure

B midgut volvulus at the time of presentation is more common than in infants

C computerized tomography scans will be nondiagnostic

D the likelihood of volvulus later in life can be predicted

E vomiting is the most common symptom[/size]

laparoscopic release of Adhesive obstruction band

Mon, 22 Nov 2021 15:50:19 +0000

see video link in second post

fecal ileal obstruction in preschool age

Thu, 24 Dec 2020 12:04:30 +0000

Hello, anyone has experience with fecal ileal obstruction in preschool age? what could be the cause and management?

18/10/2020

Sun, 18 Oct 2020 10:35:28 +0000

please write the answer and your justification, correct answer will be submitted after 48 hrs

[size=20px]A three-year old boy with no prior abdominal surgery is brought to the operating room for bowel obstruction. At surgery a left mesocolic hernia is found. The bowel can not be reduced from the hernia sac. The most appropriate maneuver with this child with intestinal obstruction is to

A mobilize the left colon along its lateral attachments.

B divide the inferior mesenteric vein.

C open the hernia sac.

D incise the colonic mesentery just to the right of the inferior mesenteric vein.

E divide Ladd’s bands.[/size]