Bowel obstruction secondary to adhesions in children: case report

Abstract

Background. Adherent bowel occlusion is the most common disease and is characterized by the formation, during the postoperative period, of non-physiological fibrotic bridges between the human, small intestine, large intestine, abdominal wall and other intra-abdominal viscera. The development of postoperative peritoneal adhesions is an almost inevitable consequence of abdominal surgery and is a major cause of morbidity and mortality. The incidence of pathology, reported in various studies, is 90-95% after laparotomies and even 97% following pelvic gynecological surgery. Analyzing the specialized literature, it can be concluded that the diagnosis and the medical-surgical treatment is based on the correct use of the diagnostic algorithm, but which must be individualized in each case even in case of association of complications. We retrospectively followed a patient with adhesive bowel occlusion. The given patient posed the problem of diagnosis and later of postoperative evolution. Case report. The patient, aged 17, was admitted to emergency surgery for abdominal pain, nausea, vomiting with food and ball content, abdominal meteorism. The patient underwent an appendectomy 3 years ago, and then a surgical reintervention: upper median laparotomy, adesiolysis, partial omentotomy, mesenteric lymphotropic therapy, abdominal cavity lavage and drainage related to: Adherential bowel occlusion. The patient is undergoing conservative drug treatment with the administration of anti-adhesive dressings. Conclusions. Adherent bowel occlusion is a current problem, and the pathophysiological mechanism as well as the means of prevention and treatment require further studies. All patients undergoing classic or laparoscopic abdominal surgery have a high risk of developing postoperative peritoneal adhesions and their complications.