AI Article Synopsis
- The study focused on pediatric patients with inflammatory bowel disease (IBD) who underwent bowel resection to understand the incidence of postoperative infections and associated symptoms.
- Out of 100 patients reviewed, 42 experienced postoperative infections, predominantly superficial surgical site infections; fever was a significant indicator of infection, affecting more than half of those with fever.
- Preoperative immunomodulating therapy did not result in higher complication rates, and routine lab tests, like C-reactive protein levels, did not effectively distinguish between complications in postoperative recovery.
Article Abstract
Introduction: Children with inflammatory bowel disease (IBD) need surgery whenever medical therapy fails. The postoperative course is frequently accompanied by symptoms suggestive of infection, such as fever. The aim of our study was to analyze the postoperative course after bowel resection in pediatric IBD patients in relation to postoperative infections.
Methods: All our pediatric IBD patients who underwent a bowel resection between 2012 and 2022 were retrospectively reviewed. Clinical data regarding surgery and the postoperative course were analyzed. The primary outcomes were signs and symptoms indicative of infection, such as fever, surgical site infection, and abscesses.
Main Results: One hundred patients underwent an IBD-related resection, of whom 69 for Crohn's disease. A total of 42 postoperative infections occurred in 26 patients, most commonly a superficial surgical site infection (38 %). Out of 48 patients who experienced postoperative fever, 52 % had an actual infection, compared to 2 % of those without fever (p < 0.001). Preoperative use of immunomodulating therapy was not associated with higher complication rates. In 35 of 48 patients with fever (73 %) laboratory tests were done as a consequence of postoperative fever, with no differences in complication rates between patients with extremely high (>200 mg/L) and high (<200 mg/L) C-reactive protein levels.
Conclusions: Occurring in over a quarter of patients, postoperative infections are common in children after undergoing IBD-related bowel resection. Postoperative fever is indicative of an infection in half of the patients. Laboratory tests, such as serum C-reactive protein, do not seem to contribute to differentiating between complicated and non-complicated course after surgery in these patients.
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| http://dx.doi.org/10.1016/j.jpedsurg.2024.162105 | DOI Listing |
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