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First week postoperative intestinal obstruction in children (Abstract)

Bilal Mirza, Afzal Sheikh

Department of Pediatric Surgery The Children’s Hospital and The Institute of Child Health, Lahore, Pakistan



Aim: This study was conducted to determine the etiology, management, and outcome of the patients that developed intestinal obstruction within 7 days of the abdominal surgery.

Material and method: Retrospectively, there were a total of 11 patients that developed early postoperative intestinal obstruction (PIO) during February 2009- Jun 2011.

Results: The mean postoperative day at which signs of intestinal obstruction developed was 3.4 day. The mean postoperative day of re-operation was 4.1 day. An increase in bilious aspirate or bilious vomiting (11 patients), abdominal distension (9 patients), constipation (8 patients), mucous or empty rectum on digital rectal examination (6 patients), and a palpable mass of intussusception (1 patient) were the clinical features of PIO. The etiology of PIO was intussusception in 4, soft adhesions in 4, internal herniation in 1, missed type IV congenital pouch colon (CPC) with colostomy twist in 1 patient, and gossypiboma in 1 patient. One patient remained critical postoperatively and expired. Intussusception and adhesions are the main causes of early PIO. Early identification and prompt management is advocated as intestinal gangrene may be followed in the early PIO.

Keywords: postoperative intestinal obstruction, intussusception, adhesions, etiology


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