Gastrografin as a Diagnostic and Therapeutic Tool In Small Bowel Obstruction: Our Experience

Dr Ajaz A Malik; Dr Shams ul Bari; Dr Khalid Bashir

Volume : VII, Issue : III, March - 2017

Gastrografin as a Diagnostic and Therapeutic Tool In Small Bowel Obstruction: Our Experience

Dr Ajaz A Malik, Dr Shams Ul Bari, Dr Khalid Bashir

Abstract :

Background: Adhesions are the leading cause of small bowel obstruction. Identification of patients who require surgery can be difficult. Gastrografin, a hyperosmolar water soluble contrast agent, has been shown to have both diagnostic as well as therapeutic benefit in such a situation. This study analyzes the role of gastrografin in the management of adhesive small bowel obstruction. Material & Methods: The study is a hospital based case control study conducted on 69 patients who were randomized into 37 cases and 32 controls. All cases underwent contrast study and were followed for 24 hours with serial abdominal radiographs. If contrast reached colon, patients were considered to have partial small bowel obstruction and were managed conservatively. If contrast failed to reach the colon and/or there was clinical deterioration, patients underwent laparotomy. Results: Patients in the contrast group passed their first stool after a mean of 6.1 hours while those in control group passed their first stool after a mean of 23.2 hours. This was statistically significant (p<0.05). The mean hospital stay was 2.4 days in contrast group and 4.8 days in control group which was also statistically significant. Only 10.9% of patients in contrast group needed surgery in comparison to 21.9% in the control group. Conclusion: The use of gastrografin in adhesive small bowel obstruction is safe and has both diagnostic as well as therapeutic benefits in the management of such patients