Water soluble contrast follow‐through in the management of adhesive small bowel obstruction: A prospective randomized trial

Abstract

Objective: Postoperative adhesive intestinal obstruction is the most common cause of small bowel obstructions in adults. The use of water‐soluble contrast follow‐through has been shown to be safe with a high predictive value for surgery. This study aims to evaluate the impact of contrast follow‐through on clinical outcomes of patients with adhesive small bowel obstructions. Methods: From July 1994 to June 1998, 150 patients were recruited into the study and randomized into two groups. One group (n = 75) received water‐soluble contrast follow‐through within 24 h of admission, whereas the control group (n = 75) did not. Both groups were put on conservative management and the outcomes measured included operative rate, postoperative morbidities, length of hospital stay and mortality. Results: The operative rate of both groups was similar (33.3 vs 38.7%, P = 0.496). The preoperative observation period (42 vs 65 h. P = 0.014) and the total median hospital stay (5 vs 7 days, P = 0.025) of the contrast group were significantly shorter than those of the control group. No significant difference could be found between the two groups in terms of postoperative morbidities and mortalities. Conclusions: In managing patients suspected to have adhesive small bowel obstruction, water‐soluble contrast follow‐through expedites the decision process for surgical intervention, which translates into a shorter hospital stay.