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Miscellaneous Causes of Intestinal Obstruction 415

Key Summary Points

1. Apart from the classical causes of mechanical bowel 4. A high index of suspicion is needed for the diagnosis of foreign
obstruction, other pathologic entities may lead to bowel bodies and bezoars in children, and psychiatric evaluation should
obstruction in children. be part of the postoperative work-up.
2. As techniques to decrease postoperative adhesions, such as 5. The mainstay of management of patients with parasitic
minimally invasive surgery, become more widespread in the obstruction is medical (antihelminthic); however, patients with
developed world, the burden of adhesions may begin to shift acute symptoms should be explored immediately after adequate
to Africa. resuscitation.
3. Children with adhesive intestinal obstruction should be 6. Sigmoid volvulus and ileosigmoid knotting, although rare in
meticulously followed; delay in operative intervention should be children, can be fulminant, making early resuscitation and
avoided. laparotomy the keys to a successful outcome.

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