Small intestinal obstruction from peritoneal adhesions in children small intestinal obstruction from peritoneal adhesions in children.
PURPOSE
The purpose of this study was to assess the incidence of peritoneal adhesions leading to small intestinal obstruction after laparotomy in children in a tertiary paediatric surgical centre.


METHODS
A retrospective review of 430 children aged <15 years who had trans-abdominal procedures over a 7 year period.


RESULTS
Four hundred and fifty nine abdominal procedures were performed in 430 children during the study period. The follow up period ranged from 4 months - 7 years (Median 33 months). 22 (4.8%) had intra-operative confirmation of small intestinal obstruction. Their ages ranged from 21 days - 14 years (median 7 years). Postoperative adhesions due to laparotomy for typhoid perforation were the commonest, occurring in 10 (45%). Children undergoing emergency laparotomy were more likely to develop post operative small intestinal obstruction compared to elective laparotomy (p<0.025). Six (27.3%) children had bowel gangrene at laparotomy requiring bowel resection and anastomosis. Post-operative small intestinal obstruction developed in 6 (27.3%). One child died due to sepsis from intestinal gangrene.


CONCLUSION
Small bowel obstruction due to adhesions requiring operative intervention in children in our setting is not un-common. Bowel gangrene is a common complication of postoperative small intestinal obstruction in children in our setting and should be suspected to avoid serious postoperative mortality and morbidity.
['Chirdan|Lb|L|', 'Soo|Ct|C|', 'Osagie|Oo|O|', 'Uba|Af|A|']
Intestinal obstruction Adhesions children