Disease variant Partial / early obstruction Complete / surgical obstruction ▼
▶ Common pathogens (1) Clinical context (Vomiting, abdominal distension, failure to pass stool/flatus — assess dehydration and electrolytes; NPO, NG decompression) First-line therapy Supportive care + surgical consult • —
Duration: Until resolved or operative · IV fluids, electrolyte correction, NG tube — antibiotics if strangulation/perforation suspected
▶ Alternative therapy Ceftriaxone + metronidazole • i.v. • 75–75 mg/kg/day • 1×/day
Duration: Perioperative / if perforation · Empiric coverage if ischemia, perforation, or postoperative infection — tailor to culture (WSES, ESPGHAN)
Clinical notes • Urgent surgical evaluation — distinguish adhesive, volvulus, meconium ileus (neonates), and postoperative ileus. ▶ More notes (2) • Imaging: upright abdominal X-ray, US; contrast studies per age and clinical picture. • Antibiotics: not routine for uncomplicated partial obstruction without perforation — give when peritonitis, necrosis, or post-op infection (SIS pediatric IAI). ▶ References & version (1) • ESPGHAN — Pediatric GI emergencies (2024) MedBalans v1.0
Updated July 2026 · Review July 2027
