SLOB

Also, unwitting clinicians are treating REFLUX that originates with colon distention and which defeats propulsion directionality. High bacterial loads in distended colons also make these kids look and feel sick. Hence we have “TOXIC” megacolon. Parallel loops of small bowel seen on hip screening x-rays should alert you to the need for a pediatric gastroenterologist, and not Nissen fundoplications for undiagnosed colonic stasis causing reverse peristalsis. A ‘poop’ ebook is in the works – check the shelf. When there is visible paralytic hip dysplasia in these children (especially those with dystonic features) then SLOB is far easier and safer than VRO or VRO plus pelvic whatever. VRO is so asymmetrical (lop sided) that it is seldom done unilaterally. Bilateral VRO is a massive metabolic hit. That metabolic combined cost overload manifests as wound problems, nonunion, metal breakage, and lots of stuff that would not otherwise be suspected. If you understand burns then you understand this. The word is not out in many places. So, we see late comers. We glossed over detail of what SLOB is. We will fix that now.