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

Abstract
Background: 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.