USING OF GASTROGRAPHIN IN ADHESIVE SMALL INTESTINAL OBSTRUCTION
DOI:
https://doi.org/10.54890/.v3i3.120Abstract
A task: To evaluate the therapeutic value o f Gastrografin in the treatm ent o f adhesive small bowel obstruction after unsuccessful conservative treatment.
Summary reference data: Gastrografin is a hyperosm olar w ater-soluble contrast agent. In addition to its diagnostic value w hen surgical intervention is required, there is probably a therapeutic role for this contrast agent in adhesive small bowel obstruction.
Criterions: In patients w ith clinical m anifestations o f adhesive small bowel obstruction, conservative treatm ent was carried out in the absence o f suspicion o f intestinal strangulation. In patients w ith a positive effect, conservative treatm ent was continued for the first 48 hours. Other patients, w ith no clinical or radiological im provem ent in the first 48 hours, were random ized to either Gastrografin or surgery. The appearance o f Gastrografin in the colon w ithin 24 hours was regarded as partial intestinal obstruction and conservative treatm ent continued. Patients in whom the contrast did not reach the colon w ithin 24 hours were considered to have complete intestinal obstruction and underwent surgical treatment. If conservative treatm ent with or w ithout Gastrografin was unsuccessful for more than 48 hours, surgery was performed. Results: The study included 84 patients. The group for the study o f Gastrografin ended up with 13 patients, and the group for surgical treatm ent - 11 patients. In 10 out o f 13 patients receiving Gastrografin, intestinal obstruction resolved w ithout surgery. The use of Gastrografin significantly reduced the need for surgical intervention (by 76.9%). The appointm ent o f Gastrografin was safe even after the ineffectiveness o f conservative treatment. Complete resolution o f intestinal obstruction occurred on average 41.0 ± 3.5 hours after adm inistration o f Gastrografin.
Conclusion: The use o f Gastrografin for adhesive ileus o f the small intestine is safe and reduces the need for surgical intervention in case of unsuccessful conservative treatment.
Keywords:
Gastrografin, R-contrast agent, adhesive intestinal obstruction, diagnostics, conservative treatmentReferences
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