Role of Water Soluble Contrast Agents in Assigning Patients to a Non-Operative Course in Adhesive Small Bowel Obstruction

Role of Water Soluble Contrast Agents in Assigning Patients to a Non-Operative Course in Adhesive Small Bowel Obstruction

Adhesive small bowel obstruction (SBO) is a common surgical emergency. It is estimated that at least 60% of SBO are due to post-operative adhesions. Water soluble contrast agents (gastrografin) have been used to identify patients who might be treated non-operatively. This study aims to determine the...

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Bibliographic Details
Published in:Oman medical journal Vol. 26; no. 6; pp. 454 - 456
Main Authors: Hassan , Khairi Ahmed, Al Awad , Naif Ibrahim, AI Wadani , Hamid
Format: Journal Article
Language:English
Published: Muscat - Oman Oman Medical Specialty Board 01-11-2011
OMJ
Subjects:
adhesive small bowel obstruction
COLITIS
Conservative management of adhesive small bowel obstruction
DIAGNOSIS
EXCISION
GASTROINTESTINAL DISEASES
MEDICAL EQUIPMENT
Original
OSMOLARITY
SAUDI ARABIA
SURGICAL OPERATIONS
THERAPY
Water soluble contrast agents
أمراض المعدة و الأمعاء
إلتهاب القولون
الأدوات الطبية
الإستئصال
التشخيص
السعودية
العلاج
العمليات الجراحية
النضحية
Water soluble contrast agents
Adhesive small bowel obstruction
Conservative management of adhesive small bowel obstruction
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Summary:Adhesive small bowel obstruction (SBO) is a common surgical emergency. It is estimated that at least 60% of SBO are due to post-operative adhesions. Water soluble contrast agents (gastrografin) have been used to identify patients who might be treated non-operatively. This study aims to determine the role of gastrografin in adhesive intestinal obstruction patients. In this prospective study, 27 patients admitted between 1(st) August 2004 and 1(st) July 2006 with clinical signs suggestive of postoperative adhesive SBO met the inclusion criteria. After intravenous hydration, nasogastric tube insertion and complete suctioning of the gastric fluid, 100 ml of gastrograsfin was given and plain abdominal radiography was taken 6 hours and 24 hours if the contrast is not seen in the colon. Those in whom the contrast reached the colon in 24 hours were considered to have partial SBO and started oral intake. If gastrografin failed to reach the colon in 24 hours and the patient did not improve in the following 24 hours, laparotomy was performed. Conservative treatment was successful in 31 cases (91%) and 3 (9%) required operation. Patients treated conservatively had short hospital stay (mean=4 days) and tolerated oral feeding with no morbidity or mortality. Oral gastrografin helps in the management of patients with postoperative adhesive SBO.
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ISSN:1999-768X
2070-5204
DOI:10.5001/omj.2011.116