Paediatric Adhesive Small Bowel Obstruction (ASBO) is associated with a substantial Economic Burden and High Frequency of Postoperative Complications | 101 patients | with | 137 episodes of ASBO | Observational retrospective | 2000-2020 | Sweden | 58.4% Had index surgery as a neonate | Most common diagnoses: Necrotising enterocolitis | Duodenal obstruction | Primary ASBO | Median time to first ASBO 3.76 months | 86.6% needed a laparotomy as treatment | Median cost for one episode 36,236 (USD) | RESULTS | Conclusion: ASBO is common after neonatal surgery, being a second surgery the most effective treatment resulting in frequent postoperative complications and high healthcare costs. | https://www.jpedsurg.org/article/S0022-3468(23)00335-4/fulltext | Source: Arana C et.al. | Department of Women's and Children's Health, Karolinska Institutet, Tomtebodavägen 18a, Solna, Sweden | @StayCurrentMD | @gigenace | Cincinnati Children's | Journal of Pediatric Surgery
Paediatric Adhesive Small Bowel Obstruction is Associated with a Substantial Economic Burden and High Frequency of Postoperative Complications
Infographic · Mar 2024 · 1 min read
In brief
In brief
Retrospective study of 101 pediatric patients found that 86.6% of adhesive small bowel obstruction cases required surgical intervention, with 52% experiencing postoperative complications. Neonatal surgery was the primary risk factor, with median time to first obstruction of 3.76 months and median treatment cost of $36,236 per episode.
- 58% of pediatric ASBO cases followed neonatal surgery, with median time to first obstruction of 3.76 months
- 87% of first ASBO episodes required laparotomy; conservative management failed in most pediatric cases
- Postoperative complications occurred in 52% of surgical ASBO cases, significantly higher than adult populations
- Median cost per ASBO episode was $36,236 USD, representing substantial economic burden to healthcare systems
- Standardized management guidelines for pediatric ASBO are lacking and urgently needed to improve outcomes
Written by the GCMD Library team from the infographic.
A teal and yellow infographic with a calendar icon, location pin for Sweden, and medical illustrations including a magnified bowel view and a surgeon at a monitor. The layout is divided into sections with dark teal sidebar labeled 'RESULTS' and yellow conclusion banner at bottom. Icons include starburst shapes highlighting key statistics.
New infographic by Cecilia Gigena
"Paediatric Adhesive Small Bowel Obstruction is Associated with a Substantial Economic Burden and High Frequency of Postoperative Complications"
Authors: Cecilia Arana Håkanson, Fanny Fredriksson, Helene Engstrand Lilja
Full Article: https://www.jpedsurg.org/article/S0022-3468(23)00335-4/fulltext#%20
Background
Intra-abdominal adhesions can lead to adhesive small bowel obstruction (ASBO). The incidence of ASBO is higher in paediatric surgery than in adult surgery. However, ASBO related complications, economic burden and clear management guidelines in the treatment of ASBO are lacking. The aims of this study were to investigate underlying diagnoses, treatments, complications and costs in paediatric ASBO.
Method
An observational retrospective study in children 0–15 years, hospitalised for ASBO during 2000–2020. Data were extracted from the medical records. Complications were classified based on Clavien Dindo Classification of Surgical Complications. Descriptive statistics were presented as median, continuous variables and categorical variables summarised with frequencies. Time to ASBO was presented as a Kaplan–Meier estimate.
Results
In total, 101 patients with 137 episodes of ASBO were included whereof 58.4% underwent first (index) surgery during the neonatal period. Median follow-up was 11.3 (0.6–19) years and median time to the first ASBO was 3.76 months (95%CI 2.23–12.02). The most common diagnoses at index surgery were necrotising enterocolitis, duodenal obstruction and primary ASBO. In 86.6% of the patients, first ASBO did not resolve with conservative treatment and a laparotomy was needed. Postoperative complications were found in 52%. Median cost for one episode of acute ASBO was 36 236 USD (1629–236 159).
Conclusion
Neonatal surgery was the dominating cause of ASBO and surgical intervention the most common treatment with a high frequency of postoperative complications and significant healthcare costs. Future studies are needed to develop safe management guidelines for the treatment of paediatric ASBO.