MÔ TẢ MỘT SỐ ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ PHẪU THUẬT TẮC RUỘT DO BÃ THỨC ĂN Ở TRẺ EM TẠI BỆNH VIỆN NHI TRUNG ƯƠNG, GIAI ĐOẠN 2017 - 2021

Abstract

Objective: Clinical characteristics, diagnose and treatment results surgery of intestinal obstruction caused by phytobezoar in children in National Pediatric Hospital period of 2017 – 2021. Subjects and methods: This is retrospective, descriptive study including all the cases of post-operative diagnosed with intestinal obstruction due to phytobezoar from January 2017 to June 2021 in National Pediatric Hospital. Results: 40 cases of bowel obstruction caused by phytobezoar, consisting of 17 males and 23 females. Patient’s age: 7 and 10; male/female percentage: 1.3/1; common clinical symptom was abdominal pain (92.5% of all cases), 75% cases was fluctuating pain; vomiting (95%), 74% cases was yellow fluid. The clear image of bowel obstruction on x- ray was 85%; on ultra sound was 50%. The essence of sub-acute development shows through extent variation of clinical symptoms and subclinical images. 13/40 treatment using laparoscopic tools was impossible; there was a small incision in the upper of umbilical performed instead. The obvious signs of bowel obstruction during an operation were 100%. Phytobezoar located in ileum was the most common case (77.5%). Treatment: push phytobezoar into colon in most of the cases (85%), the rest was opening the stomach (12.5%) and opening the small bowel (2.5%). 13 cases of laparoscopic operation, the treatment was without using laparoscopic tools, but with the help of a small incision in the upper of umbilicus. The result of treatment in early time is good. The duration of gas after surgery is 2.03±0.15 days; and staying in hospital after surgery is 4,72±0.28 days. Complications: 2 cases of infection on wounded and 3 cases of enterocolitis. They were not severe and did not need emergency operation. Conclusions: Obstruction caused by phytobezoar in children is a mechanical obstruction disorder-taking place from inside of the gastro-intestinal tract. Clinical symptoms and image diagnostics differ in the observation process, showing sub-acute essence of the disorder. Most common injury treatment was pushing phytobezoar into colon, which gave good results in early time. Laparoscopic operations still need to be examined and improved.