Wilkins B M, Spitz L
Department of Paediatric Surgery, Institute of Child Health, London, UK.
Br J Surg. 1987 Sep;74(9):777-9. doi: 10.1002/bjs.1800740907.
The incidence of postoperative adhesion intestinal obstruction among 156 children who had undergone Nissen fundoplication for intractable gastro-oesophageal reflux was determined. There were 18 episodes of obstruction in 16 patients (10.3 per cent). The mean interval between fundoplication and adhesion obstruction was 10 months (range 10 days-4 years). Additional procedures performed at the original laparotomy substantially increased the risk of developing obstruction. Relaparotomy for adhesion obstruction was required by 21 per cent of patients who had a Ladd's procedure and 12 per cent who had appendicectomy. Presenting symptoms were not typical of intestinal obstruction because many of these children were unable to vomit. Only three did vomit but all had radiological appearance suggestive of small bowel obstruction. There were two deaths directly related to adhesion obstruction.
对156例因顽固性胃食管反流接受尼森胃底折叠术的儿童术后粘连性肠梗阻的发生率进行了测定。16例患者出现了18次梗阻发作（10.3%）。胃底折叠术与粘连性梗阻之间的平均间隔为10个月（范围为10天至4年）。初次剖腹手术时进行的额外手术显著增加了发生梗阻的风险。接受拉德手术的患者中有21%以及接受阑尾切除术的患者中有12%因粘连性梗阻需要再次剖腹手术。由于这些儿童中有许多人无法呕吐，所以表现出的症状并非典型的肠梗阻症状。只有3例呕吐，但所有病例的影像学表现均提示小肠梗阻。有2例死亡与粘连性梗阻直接相关。
