The burden of adhesive bowel obstruction requiring surgery in children: a single-center retrospective review.

PURPOSE: Investigate causes, predictors, and complications of adhesive bowel obstruction (ABO) necessitating surgery in children.

METHODS

Single-center retrospective review of operative cases classified as 'adhesive bowel obstruction ' between May 2014 and December 2023. Parameters assessed included previous surgeries, operative time (indicative of adhesion extent), length of stay and postoperative complications. Results were statistically analyzed afterward.

RESULTS

We identified 71 patients with ABO; seven had recurrences. Age (11 d-18 y, median 5.9 y) and time after surgery (four days-16 years, median 6.4 months) varied considerably. Preceding appendicitis (16 cases), NEC (seven cases) and gastroschisis (five cases) were most prevalent. Operative time ranged from 43 min to 8.4 h, was longer after previous surgery during infancy (median 177 vs. 124 min), recurrent ABO (median 213 vs. 150 min) and significantly shorter after appendicitis (82 vs. 175 min). ICU stay (median 2 days) and hospital stay (median 11 days) reduced with age. 32 patients (41%) suffered complications, doubling mean lengths of stay. Bowel resection and longer surgery were associated with complications, while age and enterostomy creation were not.

CONCLUSION

ABO is an impactful complication with limited predictors. The high incidence of complications adds to the burden for patients, parents, and health systems.