TY - JOUR
T1 - The significance of abdominal radiographs with paucity of gas in pediatric adhesive small bowel obstruction
AU - Johnson, Brittany L.
AU - Campagna, Giovanni A.
AU - Hyak, Jonathan M.
AU - Vogel, Adam M.
AU - Fallon, Sara C.
AU - Shah, Sohail R.
AU - Brandt, Mary L.
AU - Naik-Mathuria, Bindi J.
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/7
Y1 - 2020/7
N2 - Purpose: Management of children with adhesive small bowel obstruction (ASBO) is often based on abdominal radiographs (AXR). Our purpose was to determine the significance of paucity of gas on initial AXR. Methods: Retrospective, single center review of children with ASBO between 2011 and 2015. Analysis included chi-square, non-parametric tests and multivariate regression. Results: Of 207 cases, 99 were operative. Initial AXR showed paucity of gas in 41% and gaseous loops in 59%. Paucity was more common in operative patients (49% vs. 32%, p = 0.01). At operation, 71% of patients with paucity had closed loop or high-grade obstruction, compared to 29% of patients with gaseous loops (p = <0.001). Conclusion: For children with ASBO with paucity of gas on AXR, complicated obstruction (closed loop or high-grade) should be considered. In children with high clinical suspicion of complicated obstruction, additional imaging with CT or SBFT may clarify the clinical picture.
AB - Purpose: Management of children with adhesive small bowel obstruction (ASBO) is often based on abdominal radiographs (AXR). Our purpose was to determine the significance of paucity of gas on initial AXR. Methods: Retrospective, single center review of children with ASBO between 2011 and 2015. Analysis included chi-square, non-parametric tests and multivariate regression. Results: Of 207 cases, 99 were operative. Initial AXR showed paucity of gas in 41% and gaseous loops in 59%. Paucity was more common in operative patients (49% vs. 32%, p = 0.01). At operation, 71% of patients with paucity had closed loop or high-grade obstruction, compared to 29% of patients with gaseous loops (p = <0.001). Conclusion: For children with ASBO with paucity of gas on AXR, complicated obstruction (closed loop or high-grade) should be considered. In children with high clinical suspicion of complicated obstruction, additional imaging with CT or SBFT may clarify the clinical picture.
KW - Abdominal radiograph
KW - Adhesive small bowel obstruction
KW - Closed loop obstruction
KW - Paucity of gas
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U2 - 10.1016/j.amjsurg.2019.10.035
DO - 10.1016/j.amjsurg.2019.10.035
M3 - Article
C2 - 31703836
AN - SCOPUS:85075347848
SN - 0002-9610
VL - 220
SP - 208
EP - 213
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 1
ER -