Attitudes Affecting Decision-Making for Use of Radiologic Enteral Contrast in the Management of Pediatric Adhesive Small Bowel Obstruction: A Survey Study of Pediatric Surgeons

J Surg Res. 2021 Nov:267:536-543. doi: 10.1016/j.jss.2021.06.004. Epub 2021 Jul 10.

Abstract

Background: Pediatric surgeons are often asked to treat clinical problems for which little high-quality data exist. For adults with adhesive small bowel obstruction (ASBO), water soluble contrast-based protocols are used to guide management. Little is known about their utility in children. We aimed to better understand key factors in clinical decision-making processes and integration of adult based data in pediatric surgeon's approach to ASBO.

Methods: We administered a web-based survey to practicing pediatric surgeons at institutions comprising the Western Pediatric Surgery Research Consortium.

Results: The response rate was 69% (78/113). Over half of respondents reported using contrast protocols to guide ASBO management either routinely or occasionally (n = 47, 60%). Common themes regarding the incorporation of adult-based data into clinical practice included the need to adapt protocols for pediatric patients, the dearth of pediatric specific data, and the quality of the published adult evidence.

Conclusions: Our findings demonstrate that pediatric surgeons use contrast-based protocols for the management of ASBO despite the paucity of pediatric specific data. Furthermore, our survey data help us understand how pediatric surgeons incorporate adult based evidence into their practice.

Keywords: Contrast protocol; Pediatric surgeon survey; Small bowel obstruction.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adhesives
  • Adult
  • Attitude of Health Personnel
  • Child
  • Decision Making*
  • Humans
  • Intestinal Obstruction* / diagnostic imaging
  • Intestinal Obstruction* / surgery
  • Surgeons*
  • Surveys and Questionnaires
  • Tissue Adhesions / diagnostic imaging
  • Tissue Adhesions / surgery

Substances

  • Adhesives