Risk factors for intestinal gangrene in children with small-bowel volvulus

Journal of Pediatric Gastroenterology and Nutrition
Yu-Pi LinChih-Cheng Luo

Abstract

Pediatric small-bowel volvulus (SBV) is a surgical emergency, and early diagnosis is difficult. We analyzed the clinical manifestations, imaging findings, and laboratory parameters in children with SBV and attempted to determine the risk factors for bowel gangrene. Forty-nine children (35 boys and 14 girls) with SBV who were admitted to the hospital for a period of 13 years were enrolled. Clinical and laboratory parameters and evaluation measures included fever, abdominal pain, vomiting, bloody stool, peritoneal signs, severe dehydration, disease duration, white blood cell counts, sugar, C-reactive protein (CRP), sodium, potassium, metabolic acidosis, blood urea nitrogen, and creatinine. These parameters were statistically compared between patients with and without bowel gangrene. Thirty-six patients (73.5%) were 5 years old or younger, and nearly half were younger than 1 year old. Abdominal pain and vomiting were 2 major symptoms. Malrotation was the most common cause of SBV. In univariate analysis, nonbilious vomiting, peritoneal signs, severe dehydration, leukocytosis (WBC count >18,000 cells/mm3), elevated CRP (>50 mg/dL), and hyponatremia (<130 mmol/L) were significantly associated with bowel gangrene (P < 0.05). In multiv...Continue Reading

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Citations

Apr 24, 2014·Pediatric Surgery International·Ilias Kanellos-BeckerMichael Boettcher
Aug 7, 2013·Emergency Medicine Clinics of North America·Seema Shah
Jan 29, 2019·Hernia : the Journal of Hernias and Abdominal Wall Surgery·J A KeeleyA Neville

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