Skip to main content
SpringerLink
Log in
Book cover

Anesthesiology pp 413–420Cite as

Anesthesia for Intestinal Obstruction

  • Chapter
  • First Online:

  • 3099 Accesses

Abstract

Intestinal obstruction is one of the most common pathologies in pediatric patients and has historically been a major cause of neonatal and infant mortality due to either an inaccurate or tardy diagnosis leading to a delay in surgical intervention and supportive care (Glover and Barry, Ann Surg 130:480–509, 1949). Earlier recognition and appropriate care has led to increased patient survival with surgical correction that is usually the definitive treatment in almost all cases. Anesthetic management for a pediatric patient with intestinal obstruction is not always straightforward and can present several challenges to the pediatric anesthesiologist. This chapter will discuss the most common causes of pediatric intestinal obstruction and the perioperative and anesthetic considerations involved in the care of these patients. Table 43.1 provides a guide to the care of newborns, infants and children with intestinal obstruction.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Glover DM, Barry FM. Intestinal obstruction in the newborn. Ann Surg. 1949;130(3):480–509.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Juang D, Snyder CL. Neonatal bowel obstruction. Surg Clin North Am. 2012;92(3):685–711, ix–x.

    Article  PubMed  Google Scholar 

  3. Gangopadhyay AN, Pandey V. Anorectal malformations. J Indian Assoc Pediatr Surg. 2015;20(1):10–5.

    Article  PubMed  PubMed Central  Google Scholar 

  4. de Blaauw I, Wijers CH, Schmiedeke E, Holland-Cunz S, Gamba P, Marcelis CL, et al. First results of a European multi-center registry of patients with anorectal malformations. J Pediatr Surg. 2013;48(12):2530–5.

    Article  PubMed  Google Scholar 

  5. Peña A, Hong A. Advances in the management of anorectal malformations. Am J Surg. 2000;180(5):370–6.

    Article  PubMed  Google Scholar 

  6. Kimura K, Loening-Baucke V. Bilious vomiting in the newborn: rapid diagnosis of intestinal obstruction. Am Fam Physician. 2000;61(9):2791–8.

    PubMed  CAS  Google Scholar 

  7. Mustafawi AR, Hassan ME. Congenital duodenal obstruction in children: a decade’s experience. Eur J Pediatr Surg. 2008;18(2):93–7.

    Article  PubMed  CAS  Google Scholar 

  8. Dalla Vecchia LK, Grosfeld JL, West KW, Rescorla FJ, Scherer LR, Engum SA. Intestinal atresia and stenosis: a 25-year experience with 277 cases. Arch Surg. 1998;133(5):490–6; discussion 6–7.

    Article  PubMed  CAS  Google Scholar 

  9. Stollman TH, de Blaauw I, Wijnen MH, van der Staak FH, Rieu PN, Draaisma JM, et al. Decreased mortality but increased morbidity in neonates with jejunoileal atresia; a study of 114 cases over a 34-year period. J Pediatr Surg. 2009;44(1):217–21.

    Article  PubMed  Google Scholar 

  10. van der Doef HP, Kokke FT, van der Ent CK, Houwen RH. Intestinal obstruction syndromes in cystic fibrosis: meconium ileus, distal intestinal obstruction syndrome, and constipation. Curr Gastroenterol Rep. 2011;13(3):265–70.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Ziegler MM. Meconium ileus. Curr Probl Surg. 1994;31(9):731–77.

    Article  PubMed  CAS  Google Scholar 

  12. Westfal ML, Goldstein AM. Pediatric enteric neuropathies: diagnosis and current management. Curr Opin Pediatr. 2017;29:347.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Seashore JH, Touloukian RJ. Midgut volvulus. An ever-present threat. Arch Pediatr Adolesc Med. 1994;148(1):43–6.

    Article  PubMed  CAS  Google Scholar 

  14. Strouse PJ. Disorders of intestinal rotation and fixation (“malrotation”). Pediatr Radiol. 2004;34(11):837–51.

    Article  PubMed  Google Scholar 

  15. Kapfer SA, Rappold JF. Intestinal malrotation-not just the pediatric surgeon’s problem. J Am Coll Surg. 2004;199(4):628–35.

    Article  PubMed  Google Scholar 

  16. Newman B, Koppolu R, Murphy D, Sylvester K. Heterotaxy syndromes and abnormal bowel rotation. Pediatr Radiol. 2014;44(5):542–51.

    Article  PubMed  Google Scholar 

  17. Powell DM, Othersen HB, Smith CD. Malrotation of the intestines in children: the effect of age on presentation and therapy. J Pediatr Surg. 1989;24(8):777–80.

    Article  PubMed  CAS  Google Scholar 

  18. Hajivassiliou CA. Intestinal obstruction in neonatal/pediatric surgery. Semin Pediatr Surg. 2003;12(4):241–53.

    Article  PubMed  CAS  Google Scholar 

  19. Marsicovetere P, Ivatury SJ, White B, Holubar SD. Intestinal intussusception: etiology, diagnosis, and treatment. Clin Colon Rectal Surg. 2017;30(1):30–9.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Mehendale S, Kumar CP, Venkatasubramanian S, Prasanna T. Intussusception in children aged less than five years. Indian J Pediatr. 2016;83(10):1087–92.

    Article  PubMed  Google Scholar 

  21. Jiang J, Jiang B, Parashar U, Nguyen T, Bines J, Patel MM. Childhood intussusception: a literature review. PLoS One. 2013;8(7):e68482.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  22. Paul SP, Candy DCA, Pandya N. A case series on intussusceptions in infants presenting with listlessness. Infant. 2010;6(5):174–7.

    Google Scholar 

  23. Lochhead A, Jamjoom R, Ratnapalan S. Intussusception in children presenting to the emergency department. Clin Pediatr (Phila). 2013;52(11):1029–33.

    Article  Google Scholar 

  24. Murat I, Humblot A, Girault L, Piana F. Neonatal fluid management. Best Pract Res Clin Anaesthesiol. 2010;24(3):365–74.

    Article  PubMed  Google Scholar 

  25. van den Heuvel I, Wurmb TE, Bottiger BW, Bernhard M. Pros and cons of etomidate—more discussion than evidence? Curr Opin Anaesthesiol. 2013;26(4):404–8.

    Article  PubMed  Google Scholar 

  26. Eger EI 2nd, Saidman LJ. Hazards of nitrous oxide anesthesia in bowel obstruction and pneumothorax. Anesthesiology. 1965;26:61–6.

    Article  PubMed  Google Scholar 

  27. Orhan-Sungur M, Apfel C, Akca O. Effects of nitrous oxide on intraoperative bowel distension. Curr Opin Anaesthesiol. 2005;18(6):620–4.

    Article  PubMed  Google Scholar 

  28. Goeller JK, Bhalla T, Tobias JD. Combined use of neuraxial and general anesthesia during major abdominal procedures in neonates and infants. Paediatr Anaesth. 2014;24(6):553–60.

    Article  PubMed  Google Scholar 

  29. Long JB, Joselyn AS, Bhalla T, Tobias JD, De Oliveira GS Jr, Suresh S, et al. The use of neuraxial catheters for postoperative analgesia in neonates: a multicenter safety analysis from the Pediatric Regional Anesthesia Network. Anesth Analg. 2016;122(6):1965–70.

    Article  PubMed  CAS  Google Scholar 

  30. Bhalla T, Shepherd E, Tobias JD. Neonatal pain management. Saudi J Anaesth. 2014;8(Suppl 1):S89–97.

    PubMed  PubMed Central  Google Scholar 

  31. Gandy RC, Wang F. Should the non-operative management of appendicitis be the new standard of care? ANZ J Surg. 2016;86(4):228–31.

    Article  PubMed  Google Scholar 

  32. Lopez JJ, Deans KJ, Minneci PC. Nonoperative management of appendicitis in children. Curr Opin Pediatr. 2017;29:358.

    Article  PubMed  Google Scholar 

  33. Kabir SA, Kabir SI, Sun R, Jafferbhoy S, Karim A. How to diagnose an acutely inflamed appendix; a systematic review of the latest evidence. Int J Surg. 2017;40:155–62.

    Article  PubMed  CAS  Google Scholar 

  34. Dudley GS. Paralytic ileus as a complication of acute appendicitis. Ann Surg. 1926;84(5):729–34.

    PubMed  PubMed Central  CAS  Google Scholar 

  35. Liu Y, Seipel C, Lopez ME, Nuchtern JG, Brandt ML, Fallon SC, et al. A retrospective study of multimodal analgesic treatment after laparoscopic appendectomy in children. Paediatr Anaesth. 2013;23(12):1187–92.

    PubMed  Google Scholar 

  36. Niraj G, Searle A, Mathews M, Misra V, Baban M, Kiani S, et al. Analgesic efficacy of ultrasound-guided transversus abdominis plane block in patients undergoing open appendicectomy. Br J Anaesth. 2009;103(4):601–5.

    Article  PubMed  CAS  Google Scholar 

  37. Abdulhai SA, Glenn IC, Ponsky TA. Incarcerated pediatric hernias. Surg Clin North Am. 2017;97(1):129–45.

    Article  PubMed  Google Scholar 

  38. Wiener ES, Touloukian RJ, Rodgers BM, Grosfeld JL, Smith EI, Ziegler MM, et al. Hernia survey of the section on surgery of the American Academy of Pediatrics. J Pediatr Surg. 1996;31(8):1166–9.

    Article  PubMed  CAS  Google Scholar 

  39. Smith J, Fox SM. Pediatric abdominal pain: an emergency medicine perspective. Emerg Med Clin North Am. 2016;34(2):341–61.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesiology, University of Minnesota, Masonic Children’s Hospital, Minneapolis, MN, USA

    Ilana Fromer M.D. & Kumar G. Belani M.B.B.S., M.S.

Authors
  1. Ilana Fromer M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kumar G. Belani M.B.B.S., M.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Hospital University Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA

    Basavana G. Goudra

  2. Department of Anesthesiology, Emory University, Atlanta, Georgia, USA

    Michael Duggan

  3. Department of Anesthesiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA

    Vidya Chidambaran

  4. University Hospitals Birmingham, Birmingham, United Kingdom

    Hari Prasad Krovvidi Venkata

  5. Emory University Hospital, Atlanta, Georgia, USA

    Elizabeth Duggan

  6. University of Alabama at Birmingham, Birmingham, Alabama, USA

    Mark Powell

  7. All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India

    Preet Mohinder Singh

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Fromer, I., Belani, K.G. (2018). Anesthesia for Intestinal Obstruction. In: Goudra, B., et al. Anesthesiology. Springer, Cham. https://doi.org/10.1007/978-3-319-74766-8_43

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-74766-8_43

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-74765-1

  • Online ISBN: 978-3-319-74766-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation