Gastrografin In Management Research Articles

Evaluation of the role of oral gastrografin in management of simple adhesive small bowel obstruction in children

Background: The risk of post-operative adhesive small intestinal obstruction is highest during the first post-operative year. Bowel injury during adhesiolysis increases the post-operative morbidity. Consequently, the conservative management of small bowel obstruction has considerable interest. The aim of this study was to evaluate the therapeutic role of gastrografin in the management of small bowel obstruction.Methods: All patients with simple adhesive small bowel obstruction will be included and treated conservatively for 48hours unless there was evidence of strangulation. After the first 48hours all the patients were given oral gastrografin unless improved or signs of strangulation arise. The evaluating parameters are the success rate, time to start full oral feeding and total duration of hospital stay.Results: Twenty-five cases were included in which two of them developed clinical evidence of strangulation during the first 48hours and were explored. Three cases improved on the conservative treatment. The remaining twenty cases were given oral gastrografin. Fourteen cases out of twenty showed the contrast dye in their large bowel by 24hours. Those 14 cases tolerated full oral feeding earlier and had shorter hospital stay than the remaining 6 cases that declared treatment failure and underwent surgical exploration.Conclusions: The use of gastrografin as a preliminary step of non-surgical treatment of simple adhesive intestinal obstruction may be helpful. However, further randomized study on a large number of patients was needed.

Clinical Values of Orally Administrated Gastrografin in Management of Adhesive Small Bowel Obstruction

AbstractBackground: Adhesive Small Bowel Obstruction (ASBO) is the most common cause of small bowel obstruction. Patients with ASBO are difficult to evaluate and to manage and their treatment is still controversial. Diagnostic and therapeutic benefits of oral gastrografin in management of patients with ASBO are investigated by several studies, but there is no consensus.Aim of the Study: The aim of the study was to assess the diagnostic and therapeutic roles in the management of ASBO of gastrografin in cases of ASBO.Material and Methods: A total of 80 patients diagnosed as ASBO were included in this study. Patients were randomized into control and gastrografin groups. In the gastrografin group 100mL of gastrografin was administered through a nasogastric tube followed by serial abdominal radiographs. Patients in whom the contrast failed to reach large bowel within 24h were considered to have complete obstruction and laparotomy was performed. Patients in whom gastrografin reach in the colon within 24h after dye administration were considered as partially obstructed, and conservative treatment was continued. The patients were operated on if signs of strangulation were developed or they failed to improve within 48h.Results: Out of forty patients with ASBO received oral gastrografin, six patients required surgical intervention with operative rate of 15% in control group. Four-teen out of forty patients treated with the traditional conservative treatment required surgical intervention with operative rate of 35% in control group. Hospital stay was shorter in gastrografin group (3.2 days), than in control group (5.3 days).Conclusion: The use of gastrografin in ASBO reduces the surgical rate, resolution time and the hospital stay.

A Prospective Study on Role of Water Soluble Contrast in Management of Small Bowel Obstruction

There is no definite protocol in management of small bowel obstruction in relation to duration and need of surgery. The aim is to study the role of gastrografin in management of small bowel obstruction. In this study patients who were diagnosed with intestinal obstruction were administered gastrografin. The patients were followed serially using x-ray at 4hrs interval for 24hrs; decision to operate was taken on non-progression of dye in two consecutive x-ray. Among 20 patients of this study 9 patients were operated on basis of gastrografin study. 11 were treated conservatively. 8 patients were of adhesive bowel obstruction. Out of which 1 was operated, 7 were treated conservatively. The sensitivity, specificity, positive and negative predictive value of gastrografin administration in this study was 100%, 89%, 92%, 100% respectively. Gastrografin helps in strengthening the clinical decision about the management of intestinal obstruction; it helps in early decision making regarding continuing the conservative or operative management and allows the introduction of oral intake earlier and earlier discharge from the hospital as well as reduction in operative rate.