P31. Preoperative predictors for postoperative gastrointestinal complications in pediatric neuromuscular scoliosis patients

Study Design: A retrospective cohort study of consecutively operated neuromuscular scoliosis patients. Background and Aim: Surgical correction of neuromuscular scoliosis can be complicated by early gastrointestinal complications, but data on the extent and severity of them is scarce. The aim of the study was to determine the incidence, course, and risk factors of gastrointestinal complications after neuromuscular scoliosis correction. Material and Methods: Ninety-one patients (<21 years of age) were consecutively operated on for neuropathic neuromuscular scoliosis during 2000–2011. Patients who developed marked postoperative gastrointestinal complications were identified and clinical, operative, and radiographic records, death certificates, and post-mortem reports were examined. Results: The average age at surgery was 14.5 (SD 2.9) and follow-up time was 4.9 (SD 2.3) years. Gastrointestinal complications occurred in 12 (13%) patients and included prolonged paralytic ileus (7%, 6/91), dysphagia (7%, 6/91), and gastroparesis (1%, 1/91). Hospital stay was 22 (SD 11) days in patients with gastrointestinal complications and 16 (SD 20) days in non-complicated patients (p = 0.005). Dysphagia required permanent feeding gastrostomy in one patient whereas other complications were transient and none caused death. The risk factors for postoperative gastrointestinal complications were preoperative main curve correction <30% in traction/bending radiographs (Relative Risk (RR) = 28 (95% Confidence Interval (CI) 4.4–180); p < 0.001), preoperative main curve >90° (RR = 5.5 (95% CI 1.3–23); p = 0.020), disturbance in intraoperative spinal cord monitoring (RR = 6.0 (95% CI 1.1–34); p = 0.043), and intravenous opioid medication over 5 days postoperatively (RR = 7.9 (95% CI 1.8–35), p = 0.006). Conclusion: Gastrointestinal complications occurred in 13% of patients after neuromuscular scoliosis correction. Marked gastrointestinal complications extended postoperative hospitalization period, but they were transient in majority (92%) of cases and none caused death. Rigid scoliosis was the most significant risk factor for gastrointestinal complications. Gastrointestinal complications appear to be less frequent after posterior only spinal fusion with total pedicle screw instrumentation and Ponte osteotomies.

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Acute pancreatitis in children with idiopathic vs neuromuscular scoliosis post surgical repair

Gastroenterology ◽

10.1016/s0016-5085(01)83198-x ◽

2001 ◽

Vol 120 (5) ◽

pp. A643-A644 ◽

Cited By ~ 1

Author(s):

D MEHTA ◽

C FESTA ◽

K DABNEY ◽

M THEROUX ◽

F MILLER

Keyword(s):

Acute Pancreatitis ◽

Surgical Repair ◽

Neuromuscular Scoliosis

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Gastrointestinal Complications

PsycEXTRA Dataset ◽

10.1037/e356932004-001 ◽

2003 ◽

Author(s):

Keyword(s):

Gastrointestinal Complications

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Low cardiac output predicts serious gastrointestinal complications after cardiopulmonary bypass operations

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0030-1269294 ◽

2011 ◽

Vol 59 (S 01) ◽

Author(s):

B Schmack ◽

P Soos ◽

A Weymann ◽

G Veres ◽

B Merkely ◽

...

Keyword(s):

Cardiac Output ◽

Cardiopulmonary Bypass ◽

Gastrointestinal Complications ◽

Low Cardiac Output

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Abdominal Textiloma Mimicking as Left Colic Tumour: A Postoperative Complication Still Common in Low-Income Countries

EMJ Radiology ◽

10.33590/emjradiol/19-00208 ◽

2020 ◽

Keyword(s):

Low Income ◽

Early Stage ◽

Low Income Countries ◽

Fistula Formation ◽

Emergency Laparotomy ◽

Intermittent Fever ◽

Gastrointestinal Complications ◽

Surgical Safety ◽

Surgical Teams ◽

Safety Rules

Retained foreign bodies have become very rare in countries where the safety rules in the operating theatre are very rigorous and follow precise guidelines. There are low-income countries where hospital structures are precarious, in which the implementation of surgical safety rules has only been effective recently. Surgical teams in these countries are not yet well trained in the observance of the guidelines concerning swab count, meaning that textilomas are not uncommon. Abdominal textiloma may be asymptomatic, or present serious gastrointestinal complications such as bowel obstruction, perforation, or fistula formation because of misdiagnosis. It may mimic abscess formation in the early stage or soft tissue masses in the chronic stage. This case report presents a 27-year-old female who underwent an emergency laparotomy in a rural surgical centre for an ectopic pregnancy. Two months later, a swelling had appeared on the left side of her abdomen, gradually increasing in size, which was not very painful but caused digestive discomfort and asthenia. Intermittent fever was described and treated with antibiotics. The patient was referred to a better equipped centre to benefit from a CT scan. A textiloma was strongly suspected on the CT but a left colic mass was not excluded. Laparotomy confirmed the diagnosis of textiloma and the postoperative course was uneventful. Prevention rules must be strengthened in these countries where patients can hardly bear the costs of iterative surgeries for complications that are avoidable.

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