Role Of Gastrografin In Management Of Small Bowel Obstruction After Failure Of Conservative Treatment (Prospective Randomized Study)
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Background : Oastrografin is ahyperosmolar water soluble contrast medium. Besides its predictive value for the need of surgery in bowel obstruction, it may have a therapeutic role in relieving particular categones ot adhesive small bowel obstruction. Objectives: To evaluate the effectiveness of using Gastrografn in relieving adhesive small bowel obstruction after unsuccessful conservative treatment. Patients .4,8,4ethods : Thirty-five patients with clinical and. radiological evidence of adhesive small bowel obstruction and did not show improvement within the initial 48 hoUrs of conservative therapy were randomized unto two groups. Contrast that appeared in the large bowel within 24 hours was regarded as a partial obstruction, aml conservative treatment was continued. Patients in whom contrast failed to reach the large bowel within 24 hours were considered to have complete obstruction, and laparotomy was performed. Results : Gastrografin group study (n.•19) revealed partial obstruction in 14 patients. Obstruction resolved subsequently in all of them after 41±23 hours. 5 patients underwent laparotonty because the contrast study showed complete obstruction. The use of Castro:n:1Pu significantly 'educed the need for surgery by 74% (p < 0.01) Conclusion : The use of Gastrografin in adhesive small bowel obstruction is safe, cost-effective and reduces the need for surgery when conservative treatment fails.