Role of water soluble contrast in adhesive small bowel obstruction, a prospective randomised control trail

Bhuban Mohan Das; Sushil Kumar Pattanaik; Prafulla Dash; Abhinash Sahoo; B.Nembian Raja Rajan

doi:10.18203/2320-6012.ijrms20174922

Authors

Bhuban Mohan Das Department of General Surgery, SCBMCH Cuttack, Odisha, India
Sushil Kumar Pattanaik Department of General Surgery, SCBMCH Cuttack, Odisha, India
Prafulla Dash Department of Radiology, SCBMCH Cuttack, Odisha, India
Abhinash Sahoo Department of General Surgery, SCBMCH Cuttack, Odisha, India
B.Nembian Raja Rajan Department of General Surgery, SCBMCH Cuttack, Odisha, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20174922

Keywords:

Urografin, SAIO, WSCA

Abstract

Background: The aim of this study was to assess the diagnostic and therapeutic role of urografin (water soluble contrast agent) in patients with adhesive small bowel obstruction.

Methods: This was a prospective study conducted in the department of surgery in association with the department of Radiology, in S.C.B.M.H, Cuttack. Odisha India. Total patients with clinical and radiological evidence of adhesive SBO were selected for this study. The primary outcome in the diagnosis role of WSCA was its ability to predict the need for surgery.in the therapeutic role, the following were evaluated, resolution of SBO without surgery, time from admission to resolution, duration of hospital stays, complications and mortality.

Results: 129 prospective patients were included. The appearance of contrast in the colon within 4-24 Hrs, after administration had a sensitivity of 96 percent and specificity of 98 percent in predicting resolution of SBO.

Conclusions: Water soluble contrast agent (urografin) was effective in predicting the need for surgery in patients with adhesive SBO. In addition, it reduced the need for operation and shortened hospital stay.

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References

Playforth RH, Holloway JB, Griffin WO. Mechanical small bowelobstruction: a plea for early surgical intervention. Ann Surg. 1970;171:783-8.

Seror D, Feigin E, Szold A, et al. How conservative can postoperative small bowel obstruction be treated? Am J Surg. 1993;165:121-6.

Tanphiphat C, Chittmittrapap S, Prasopsunti K. Adhesive small bowel obstruction. A review of 321 cases in a Thai hospital. Am J Surg. 1987;154:283-7.

Blackmon S, Lucius C, Wilson JP, et al. The use of water-soluble contrast in evaluating clinically equivocal small bowel obstruction. Am Surg. 2000; 66:238-44.

Chen SC, Chang KJ, Lee PH, et al. Oral Urografin in postoperative small bowel obstruction. World J Surg. 1999;23:1051-4.

Chen SC, Lin FY, Lee PH. Water-soluble contrast study predicts the need for early surgery in adhesive small bowel obstruction. Br J Surg. 1998; 85:1692-4.

Wilson MS, Ellis H, Menzies D. A review of the management of small bowel obstruction. Ann R Coll Surg Engl. 1999;81:320-8.

Assalia A, Schein M, Kopelman D. Therapeutic effect of oral Gastrografin in adhesive, partial small-bowel obstruction: A prospective randomized trial. Surg. 1994;115:433-7.

Assalia A, Kopelman D, Bahous H. Gastrografin for mechanical partial, small bowel obstruction due to adhesions. Harefuah. 1997;132:629-33.

Feigin E, Seror D, Szold A, et al. Water-soluble contrast material has no therapeutic effect on postoperative small-bowel obstruction: Results of a prospective randomized clinical trail. Am J Surg. 1996;171:227-9.

Fevang BT, Jensen D, Fevang J, et al. Upper gastrointestinal contrast study in the management of small bowel obstruction—a prospective randomized study. Eur J Surg 2000; 166:39–43.

Cox MR, Gunn IF, Eastman MC, et al. The operative aetiology and types of adhesions causing small bowel obstruction. Aust NZ J Surg. 1993; 63:848-52.

Matter I, Khalemsky L, Abrahamson J. Does the index operation influence the course and outcome of adhesive intestinal obstruction? Eur J Surg. 1997; 163:767-72.

Farid M, Fikry A, El Nakeeb A, Fouda E, Elmetwally T, Yousef M. Clinical impacts of oral Gastrografin follow-through in adhesive small bowel obstruction (SBO). J Surg Res. 2010;162:170-6.

Safamanesh S, Pazouki A. Evaluation of Gastrografin Therapeutic Role in the Management of Small Bowel Obstruction, J Minim Invasive Surg. Sci. 2012;1(3):90-3.

Choi H, Chu K, Law W. Therapeutic Value of Gastrografin in Adhesive Small Bowel Obstruction After Unsuccessful Conservative Treatment, Annals Surg. 2002;236(1):1-6.