Bonnard A, Kohaut J, Sieurin A, Belarbi N, El Ghoneimi A
Department of General Pediatric Surgery, Robert Debré Hospital and Paris VII University, APHP, Robert Debré Hospital, 48, Boulevard Sérurier, 75019, Paris, France.
Pediatr Surg Int. 2011 Dec;27(12):1277-81. doi: 10.1007/s00383-011-2963-8. Epub 2011 Aug 5.
The risk of bowel injury during surgery for small bowel obstruction (SBO) has generated interest in conservative treatment modalities. Few data are available on conservative Gastrografin treatment for SBO in children.
We prospectively included patients with uncomplicated adhesive SBO managed at a pediatric center between March 2009 and September 2010. Patients who were unimproved after 48 h of conservative treatment received 50-100 ml of Gastrografin. If Gastrografin was seen in the cecum on the abdominal radiograph 4-6 h later, feeding was initiated and the patient was discharged on the same day. Each patient was matched to 2 controls on the number of previous SBO episodes. The primary outcome was length of hospital stay (>3 days), and the secondary outcome was time from admission to first feed (>2 days). Both were compared in the two groups using conditional logistic regression.
The 8 patients admitted for SBO were matched to 16 controls. Gastrografin administration was associated with significantly lower risks of staying in the hospital longer than 3 days (P < 0.10) and waiting more than 2 days before the first feed.
This preliminary study suggests that Gastrografin may be useful for managing adhesive SBO in children.
小肠梗阻（SBO）手术期间肠道损伤的风险引发了人们对保守治疗方式的兴趣。关于儿童SBO的保守泛影葡胺治疗的可用数据很少。
我们前瞻性纳入了2009年3月至2010年9月在一家儿科中心接受治疗的单纯性粘连性SBO患者。保守治疗48小时后病情无改善的患者接受50 - 100毫升泛影葡胺。如果4 - 6小时后腹部X光片显示泛影葡胺到达盲肠，则开始喂食，患者于同日出院。根据既往SBO发作次数为每名患者匹配2名对照。主要结局是住院时间（>3天），次要结局是从入院到首次喂食的时间（>2天）。使用条件逻辑回归对两组的这两个结局进行比较。
8例因SBO入院的患者与16名对照匹配。给予泛影葡胺与住院超过3天（P < 0.10）和首次喂食前等待超过2天的风险显著降低相关。
这项初步研究表明，泛影葡胺可能有助于治疗儿童粘连性SBO。
