Adhesive small-bowel obstruction in children: predictors of vascular compromise of the intestine

The records of 228 episodes of adhesive small-bowel obstruction (ASBO) in 179 children were reviewed retrospectively to evaluate criteria to predict the presence of vascular compromise of the intestine and to establish safety limits for conservative treatment. Among 228 episodes of ASBO, 16 (7%) were associated with vascular compromise while 212 (93%) were without. The predictability of the proposed criteria, which included localized abdominal tenderness, tachycardia, fever, and leukocytosis was studied individually and in combination. Of the individual criteria, the presence of tachycaria and localized abdominal tenderness correlated significantly with the presence of vascular compromise (P