Surgical Management of Adhesive Bowel Obstruction in Pediatric Patients: A Narrative Review of Current Evidence
Keywords:
adhesive bowel obstruction, pediatric surgery, adhesiolysis, laparoscopy, adhesion, small bowel obstruction, pathophysiology, children, non-operative managementAbstract
Adhesive small bowel obstruction (ASBO) is a frequent and clinically significant complication following abdominal surgery in children, contributing to substantial morbidity, repeated hospitalizations, and economic burden. This narrative review synthesizes evidence from 20 recent publications to evaluate the epidemiology, pathophysiology, and surgical management strategies for pediatric ASBO. A structured literature search was conducted across PubMed, Scopus, and Google Scholar, encompassing studies published between 2019 and 2026. The review identifies that ASBO incidence ranges from 3% to 14% depending on the index surgical procedure, with neonatal conditions such as malrotation and gastroschisis carrying the highest risk. Non-operative management succeeds in approximately 54–64% of cases, while laparoscopic adhesiolysis demonstrates shorter hospital stays and fewer complications compared with open laparotomy. Anti-adhesive barriers show emerging promise but lack robust pediatric evidence. Future research should prioritize multicenter randomized trials and standardized management protocols to optimize outcomes for this vulnerable population.
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