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Polish Journal of Surgery

The Journal of Foundation of the Polish Journal of Surgery

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Ileus and Intestinal Obstruction - Comparison Between Children and Adults

Mehran Peyvasteh1 / Shahnam Askarpour1 / Hazhir Javaherizadeh1 / Somaieh Taghizadeh1

Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahwaz, Iran1

Arvand International Division, Ahvaz Jundishapur University of Medical Sciences2

This content is open access.

Citation Information: Polish Journal of Surgery. Volume 83, Issue 7, Pages 367–371, ISSN (Print) 0032-373X, DOI: 10.2478/v10035-011-0058-9, September 2011

Publication History

Published Online:
2011-09-21

Ileus and Intestinal Obstruction - Comparison Between Children and Adults

Bowel obstruction is the interference with movement of bowel content. Large and small in testing from duodenum to anal region can be obstructed mechanical or non-mechanical and complete or partial. Mechanical obstruction can presented because of obstructive causes in intestinal lumen, intestinal wall or pressure from other tissue on intestine.

The aim of the study was to evaluate etiology, laboratory findings of intestinal obstruction and ileus among children and adults who discharged with good condition.

Material and methods. This retrospective study was carried out from 2001 to 2006 in Imam Khomeini Hospital (Ahvaz-Iran). Cases of bowel obstruction were included in this study. For each case, a questionnaire was filled. There are 752 cases with suspected bowel obstruction. From 752 cases, 403 patients that agreed and treated and discharged with good condition were studied. Cases were divided into two groups: children (age < 15 yrs) and adults (age> 15 yrs). Data were analyzed by SPSS Ver 16.0 (Chicago, IL, USA) and Epi-info Ver 6.00.

Results. In our study, 221 adults and 192 children were included. Mortality rate was 12.2%. Forty-eight percent of 403 cases were children (m - 61%, f - 38%, ambigus genitalia - 1%) and 52% were adults (m - 67%, f - 33%). Etiology of bowel obstruction in children were as follows: ileus (26%); adhesion band (17.7%), partial obstruction (16.1%), and Hirschsprung's disease (12%). Causes of bowel obstruction in adults are: partial obstruction (29.9%); ileus (19%); adhesion band (18.5%); colonic pseudo obstruction(8.5%); GI cancer (5.2%); hernia (4.7%); Crohn (2.8%); fecal impaction (3.3%); bezoar (2.4%), and 4.7% for other causes. Fifty-one percent of children and 36% of adults were operated. Of all children, 91.7% had upright abdominal X-ray, 51.6% had supine X-ray, and 80.7% had sonography. Hundred percents of adults had upright & supine plain abdominal X-ray and 75.4% had sonography. Most change in children's CBC was 10000<WBC<15000 and in adult for WBC<10000.

Conclusions. Partial obstruction, pseudo-obstruction, and cancer were more common in adults than children. Ileus was the commonest cause of obstruction in children and it was partial obstruction for adult. Children were more operated than adult. Sonography was more use for children but plain abdominal X-ray for adult. In 45% of children 10000<WBC<15000 while most adult had WBC<10000. Hypokalemia was the most common biochemical finding in both group.

Keywords: bowel obstruction; ileus; adhesion band; Hirschsprung; intussusceptions; fecal impaction; colonic pseudo obstruction; diverticulitis; hernia; imperforate anus

  • Mucha P Jr: Small intestinal obstruction. Surg Clin North Am 1987; 67: 597-620. [PubMed]

  • Miller G, Boman J, Shrier I et al.: Natural history of patients with adhesive small bowel obstruction. Br J Surg 2000; 87: 1240-47.

  • Muthukumarasamy G, Venkata SP, Shaikh IA, et al.: Gallstone ileus: surgical strategies and clinical outcome. J Dig Dis 2008; 9 (3): 156-61. [PubMed] [CrossRef] [Web of Science]

  • Nobie BA. Small bowel obstruction. Available at: http://www.emedicine.com/emerg/topic66.thm

  • Philps RK, Hittinger R, Fry JS et al.: Malignant large bowel obstruction. Br J Surg 1985; 72(4): 296-302.

  • No author listed. Large bowel obstruction. Available at: http://surgical-tutor.org.uk

  • McCowan C: Large bowel obstruction. Available at: http://www.emedicine.com/emerg/topic65.htm

  • Malik AM, Shah M, Pathan R et al.: Pattern of Acute Intestinal Obstruction: Is There a Change in the Underlying Etiology? Saudi J Gastroenterol 2010; 16(4): 272-74. [CrossRef]

  • Markogiannakis H, Messaris E, Dardamanis D et al.: Acute mechanical bowel obstruction: clinical presentation, etiology, management and outcome. World J Gastroenterol 2007; 21; 13 (3): 431-37.

  • Renzulli P, Krahenbuhl L, Sadowski C et al.: Modern diagnostic strategy in ileus. Zentralbl Chir 1998; 123: 1334-39. [PubMed]

  • Ogundoyin OO, Afolabi AO, Ogunlana DI: Pattern and outcome of childhood intestinal obstruction at a Tertiary Hospital in Nigeria. Afr Health Sci 2009; 9(3): 170-73.

  • Tamijmarane A, Chandra S, Smile SR: Clinical aspects of adhesive intestinal obstruction. Trop Gastroenterol 2000; 21: 141-43. [PubMed]

  • Oladele AO, Akinkuolie AA, Agbakwuru EA: Pattern of intestinal obstruction in a semi urban Nigerian hospital. Niger J Clin Pract 2008; 11:347-50.

  • Croome KP, Colquhoun PHD: Intussusception in adult. Can J Surg 2007; 50 (6): 13-14.

  • Kaiser AD, Applegate KE, Ladd AP: Current success in the treatment of intussusceptions in children. Surg 2007; 142 (4): 469-75. [PubMed]

  • Moon SK, Lee GS, Lee ES et al: A case report of intestinal obstruction caused by strangulated femoral hernia accompanying soft tissue necrosis. Korean J Gastroentrol 2007 Nov; 50(2): 340-43.

  • Madziga AG, Nuhu AI: Causes and treatment outcome of mechanical bowel obstruction in north eastern Nigeria. West Afr J Med 2008 Apr; 27 (2): 101-05. [PubMed]

  • Dijkstra FR, Nieuwenhuijzen M, Reijnen MM et al.: Recent clinical developments in pathophysiology, epidemiology, diagnosis and treatment of intra-abdominal adhesions. Scand J Gastroenterol Suppl 2000; 232: 52-59. [PubMed]

  • Menzies D, Ellis H: Intestinal obstruction from adhesions-how big is the problem? Ann R Coll Surg Engl 1990; 72: 60-63.

  • Ihedioha U, Alani A, Modak P et al.: Hernias are the most common cause of strangulation in patients presenting with small bowel obstruction. Choose Destination

  • Kössi J, Salminen P, Laato M: The epidemiology and treatment patterns of postoperative adhesion induced intestinal obstruction in Varsinais-Suomi Hospital District. Scandinavian Journal of Surgery 2004; 93(1): 68-72.

  • Chen XZ, Wei T, Jiang K et al.: Etiological factors and mortality of acute intestinal obstruction: a review of 705 cases. Zhong Xi Yi Jie He Xue Bao 2008; 6(10): 1010-16.

  • Wyoski A, Kryzon J: Causes of intestinal obstruction. Przegl Lek 2005; 58(6): 507-08.

  • Mohamed AY, al-Ghaithi A, Langevin JM et al.: Causes and management of intestinal obstruction in a Saudi Arabian hospital. J R Coll Surg Edinb 1997; 42: 21-23.

  • Penco JM, Murillo JC, Hernandez A et al.: Anomalies of intestinal rotation and fixation: consequences of late diagnosis beyond two years of age. Pediatr Surg Int 2007; 23: 723-30. [PubMed] [Web of Science] [CrossRef]

  • Chen Y, Tseng SH, Lai HS et al.: Primary volvulus of the small bowel in a preterm infant. J Fomos Med Assoc 2003; 102: 896-98.

  • Ameh EA, Nmadu PT: Intestinal volvulus: aetiology, morbidity and mortality in Nigerian children. Pediatr Surg Int 2004, 16: 50-52.

  • Bielecki K, Kaminski P: Management of large bowel obstruction-own observation. Wiad Lek 2007; 60(7-8): 312-20. [PubMed]

  • Dakubo JC, Akoto H, Etwire VK et al.: Ileal stricture following strangulated inguinal hernia. Trop Doct 2007; 37(4):260-62. [Web of Science] [PubMed] [CrossRef]

  • Jeong WK, Lim SB, Choi HS et al.: Conservative Management of adhesive small bowel obstruction in patients previously operated for primary colorectal cancer. J Gastrointestinal Surg 2008; 12(5): 926-32. [CrossRef] [Web of Science]

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