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Pediatric Intestinal Obstruction, Management and Outcomes: A Simple Literature Review

Background: Acute intestinal obstruction occurs when there is an interruption in the forward flow of intestinal contents. This interruption can occur at any point along the length of the gastrointestinal tract, and clinical symptoms often vary based on the level of obstruction. Intestinal obstruction in children can occur as a result of various causes such as, intussusception, adhesive small bowel obstruction, malrotation, and Hirschsprung’s disease. In this review paper we will go through the literatures that have been investigated to assess the various management measures and its outcomes. 
Objective: In this review we aimed at assessing of different management plans of gastrointestinal obstruction in different conditions like Intussusception, Congenital Duodenal Obstruction and Adhesive Small Bowel Obstruction (ASBO), and the outcomes related. Moreover, providing a reference paper analyzing all the clinical studies in this field. 
Methods: PubMed database was used for articles selection, and the following keys used in the Mesh ("Intestinal Obstruction/diet therapy"[Mesh] OR "Intestinal Obstruction/drug effects"[Mesh] OR "Intestinal Obstruction/ drug therapy"[Mesh] OR "Intestinal Obstruction/surgery"[Mesh] OR "Intestinal Obstruction/ therapy"[Mesh]). 
Results: Intussusception should be treated with hydrostatic reduction (HR) even with more than one try because this method was associated with high success rate. After successful HR, patient can be discharged from ED if there were no suspected complications. Surgical treatment is indicated mostly in cases of complications. Manual reduction was associated with significantly better post-operative outcomes and lesser time to recovery. It is advised not to maintain high threshold for resection in order to avoid post-operative recurrence or perforation. The use of Gastrografin in treating children with adhesive small bowel obstruction when the conservative management fails is safe. However, half of the patients will need surgical management after all. 
Conclusion: The laparoscopic approach in the management of congenital duodenal obstruction can be performed in neonates safely. It showed similar outcomes to the open approach despite the presence of high conversion rate.