The HPI I had presented on was based on a pediatric patient who presented with abdominal pain, nausea and vomiting and was diagnosed with a small bowel obstruction (SBO). It was an interesting case because I wasn’t sure if the approach and management for a small bowel obstruction was the same in pediatric patients as it is for adults. My journal article focused on the acute management and treatment of small bowel obstruction in the pediatric population. The article discussed diagnosis and initial management which included history, physical exam, imaging and emergent laparotomy for anyone presenting with signs of bowel ischemia. For those children not presenting with signs or symptoms of ischemia, management includes bowel rest, NG tube for enteral decompression, fluid resuscitation and correction of electrolyte abnormalities. The article also mentioned the controversy over whether CT is needed to diagnose an SBO and whether it is beneficial for pediatric patients. The conclusion that was made based on some studies is that CT is not necessarily needed to diagnose an SBO, but it does have the potential to identify patients with high-grade obstruction. Non-operative management was also a topic of discussion, but the use of non-operative management is really dependent on the extent of the obstruction. Timing of surgery is also essential to consider to avoid risk of bowel resection. Studies have shown that children who underwent surgery within the first 48 hours were less likely to require bowel resection compared to those who had surgery on days 3-14. Alternative therapies for SBO are still underway, but gastrografin is one possible therapeutic intervention. All in all, the management and treatment of SBO is very much similar to that of adults.