{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T01:48:19Z","timestamp":1770515299053,"version":"3.49.0"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,8,15]],"date-time":"2016-08-15T00:00:00Z","timestamp":1471219200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"The Ministry of Health, Labour Sciences Research","award":["H24-037"],"award-info":[{"award-number":["H24-037"]}]},{"name":"The Ministry of Health, Labour Sciences Research","award":["H26-045"],"award-info":[{"award-number":["H26-045"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Determining the cause of bowel obstruction without a history of laparotomy (BO without HL) is difficult and can result in delay of treatment and development of a potentially life\u2010threatening situation. We herein investigated the clinical characteristics of pediatric patients who underwent laparotomy due to BO without HL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All surgical pediatric patients aged &lt;16 age who were diagnosed with BO without HL between January 2004 and September 2014 were included. Etiology of BO, intraoperative findings and postoperative outcome were investigated retrospectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy patients were diagnosed with BO without HL in this period. In these 70 patients, malrotation (<jats:italic>n<\/jats:italic> = 34), intussusception (<jats:italic>n<\/jats:italic> = 19), internal hernia (<jats:italic>n<\/jats:italic> = 6) and Meckel's diverticulum (<jats:italic>n<\/jats:italic> = 5) were predominantly identified. Regarding preoperative definitive diagnosis, prevalence of internal hernia, Meckel's diverticulum or idiopathic volvulus was significantly lower than that of malrotation or intussusception (<jats:italic>P<\/jats:italic> &lt; 0.05). Intraoperatively, the rates of strangulation and bowel resection were 55.7% and 30.0%, respectively. The optimal time for emergency operation in order to avoid strangulated bowel resection was &lt;19 h from onset of symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Malrotation and intussusception are major causes of BO without HL in children, but internal hernia, Meckel's diverticulum and idiopathic volvulus should always be taken into account, particularly because of the preoperative diagnostic difficulty and resulting high rate of intestinal resection. In order to avoid resection of the bowel, surgery should be done within 19 h before bowel ischemic change occurs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.13003","type":"journal-article","created":{"date-parts":[[2016,4,10]],"date-time":"2016-04-10T16:10:59Z","timestamp":1460304659000},"page":"1205-1210","source":"Crossref","is-referenced-by-count":13,"title":["Bowel obstruction without history of laparotomy: Clinical analysis of 70 patients"],"prefix":"10.1111","volume":"58","author":[{"given":"Koichiro","family":"Yoshimaru","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiaki","family":"Kinoshita","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiharu","family":"Matsuura","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Genshiro","family":"Esumi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Momoko","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Japan Community Health care Organization Kyushu Hospital  Kitakyushu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiaki","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Yanagi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Hayashida","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Miyazaki Prefectural Miyazaki Hospital  Miyazaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Ieiri","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Kagoshima University Graduate School of Medical and Dental Sciences  Kagoshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoaki","family":"Taguchi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences Kyushu University  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,8,15]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"116","volume-title":"The Acute Abdomen in Infancy and Childhood","author":"Raffensperger JG","year":"1970"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-012-0207-8"},{"key":"e_1_2_8_4_1","first-page":"188","article-title":"Etiology of intestinal obstruction in patients without a prior history of laparotomy or a detectable external hernia on physical examination","volume":"91","author":"Omori H","year":"2006","journal-title":"Int. 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