Pediatric Abdominal Adhesions

  • Etiology: bands of scar tissue occurring as a complication of previous abdominal surgery
  • AXR: small bowel obstruction
  • Small bowel follow through: abrupt small bowel luminal narrowing with dilation of the bowel proximal to the adhesion
  • Complications: partial or complete small bowel obstruction
  • Treatment: may respond to bowel decompression and watchful waiting, otherwise surgery is required to lyse the abdominal adhesion

Radiology Cases of Abdominal Adhesions

SBFT of small bowel obstruction due to abdominal adhesions
AXR supine (left) shows several dilated loops of bowel in the left upper quadrant. Upper GI and small bowel follow through delayed image (right) shows contrast filling several dilated loops of jejunum with no contrast passing distally into the colon.

Surgery Cases of Abdominal Adhesions

Surgical image of small bowel obstruction due to abdominal adhesions
Surgical image shows dilated and congested loops of small intestine in the upper right corner and normal sized decompressed loops of small bowel adjacent to them. A volvulus was noted at the level of the terminal ileum, caused by adhesions from the cecum to the small bowel, forming a closed loop obstruction that was causing bowel wall congestion.