EP.FRI.450 Gastrograffin use in Non-Adhesional Small bowel Obstruction

Abstract

Abstract Aims Use of Gastrograffin (GG) radio-opaque contrast has been documented in the management of adhesional small bowel obstruction. It is not widely used in other causes of small bowel obstruction. The aim of this study was to assess the effectiveness of GG use in non-adhesive small bowel obstructions. Methods A retrospective review of patients who had GG administered following CT confirmed small bowel obstruction (SBO) over 2-year period was conducted. Demographics, cause of SBO and outcomes were recorded. The primary outcome was resolution of SBO with GG. Results 80 patients received GG for management of radiologically confirmed small bowel obstruction. The mean age was 62.7 years +/- 14.64 (SD) and M:F ratio was 1:1. The causes of small bowel obstruction included adhesions (n = 37, 46%), hernias (n = 17, 21%), progression of known cancer (n = 3, 4%). 18% (n = 15) had no clear cause of SBO on CT. In the adhesion group, GG resolved SBO in n = 27 (73%) of patients. In the hernia group 7 (41%) were incisional hernias and 7 (41%) were parastomal hernias. GG was given to both groups and the obstruction resolved in n = 6 (86%) and n = 4 (57%) of cases respectively. Conclusions This study shows the effective use of GG in hernia related SBO where there is no absolute indication for surgery. GG might be suitable for incisional and parastomal hernias as a bridge to resolving acute SBO allowing a delayed repair with complex techniques.