Prevention and treatment of enteroparesis in children

Abstract

O.S. Pen’tkovskaya1, S.I. Bardenikova2 1St. Vladimir Children’s City Clinical Hospital, Moscow, Russian Federation 2A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation Dynamic intestinal obstruction (DIO) is one of the disorders reported after gastrointestinal (GI) surgical procedures. DIO raises special concerns, as it affects patients’ condition in the postoperative period and increases the duration of hospital treatment. The review section of the article is focused on DIO pathogenetic mechanisms, clinical manifestations, diagnostic criteria, and treatment strategies. In addition to diet therapy and the use of cholinesterase inhibitors, the conservative therapy in children includes various physiotherapy treatment techniques, facilitating intestinal motility. The comparative analysis shows that their ultimate efficiency is not the same and that there are significant limitations and differences associated with the access to the optimal areas for electrode placement. The article presents the results of introducing an original technique of dynamic electrical stimulation of the intestine with point paravertebral massage which wa s used in the early postoperative period for 117 children. The children had undergone either emergency surgeries in cases of acute surgical conditions or planned (stage-by-stage) intestinal reconstruction surgeries for preventing DIO.The data have demonstrated the efficacy of electrical stimulation used both as monotherapy and in combination with proserine (the number of required injections was decreased to 1 or 2). Restoration of the intestinal passage was achieved in 95% of cases within the first 24–36 hours after surgery (spontaneous defecation occurred in 70% of patients by the end of the first day). A later response to electrical stimulation with the restoration of peristalsis was determined after small intestine surgeries: spontaneous emptying of the intestine on the first day occurred only in 43% of children versus 52% after surgery of the lower portion of the abdominal cavity Keywords: postoperative intestinal paresis; children; clinical course; diagnostics; electrical stimulation; original technique; acupressure device. For citation: Pen’tkovskaya O.S., Bardenikova S.I. Prevention and treatment of enteroparesis in children. Russian Journal of Woman and Child Health. 2022;5(4):373–381 (in Russ.). DOI: 10.32364/2618-8430-2022-5-4-373-381.