Prospective Evaluation of Oral Gastrografin® in the Management of Postoperative Adhesive Small Bowel Obstruction

Rahmani, Nasrin; Tahamtan, R A Mohammadpour; Khoshnood, Peyman; Ahmadi, Amirhossein; Assadpour, Sara

doi:10.1007/s12262-012-0479-7

Cited by 20 publications

(12 citation statements)

References 15 publications

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“…In the present study, 56 patients with small intestinal obstruction (56/80) who received Gastrografin had a good clinical outcome, which included 45 cases of adhesive obstruction. Similar findings have been reported in recent studies [20,21].…”

Section: Discussionsupporting

confidence: 93%

Diagnostic Value of Plain and Contrast Radiography, and Multi-slice Computed Tomography in Diagnosing Intestinal Obstruction in Different Locations

Liu

Sun

2015

Indian J Surg

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Early intestinal obstruction is easily misdiagnosed. Many physicians consider terminal bouton if computed tomography (CT) scan is done. However, different examinations provide diverse information and significance. This retrospective, randomized, clinical study investigated the diagnostic value of three imaging modalities for intestinal obstruction, supine and upright (or decubitus) plain abdominal radiography, contrast radiography using Gastrografin, and 64 multi-slice spiral CT (MSCT). A total 142 patients with intestinal obstruction were examined. The diagnostic accuracy of plain radiography, contrast radiography, and MSCT for detecting small bowel obstruction was 62.5, 85, and 77.5 %, for localizing the obstruction was 0, 90, and 78.75 %, and for determining the cause of obstruction was 0, 71, and 65 %, respectively. The diagnostic accuracy for detecting large bowel obstruction was 53.23, 73.17, and 92 %, and for localizing the obstruction was 38.17, 60.98, and 98 %, respectively. The diagnostic accuracy of MSCT in determining the cause of obstruction was 91 %. None of the patients administered Gastrografin experienced any adverse effects. In conclusion, MSCT has great diagnostic value in identifying the site and cause of intestinal obstruction, especially in cases of large bowel obstruction. Contrast radiography using Gastrografin was effective in diagnosing and treating small bowel obstruction, making it a beneficial adjunct to MSCT.

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Section: Discussionsupporting

confidence: 93%

Diagnostic Value of Plain and Contrast Radiography, and Multi-slice Computed Tomography in Diagnosing Intestinal Obstruction in Different Locations

Liu

Sun

2015

Indian J Surg

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“…Among the remaining articles, 116 were excluded by title/abstract review on the basis of their selection criteria and PICO. The remaining 17 articles were screened by full‐text review, after which 12 studies including a total of 1153 patients with PSBO were regarded as suitable for inclusion in the data synthesis . The selection process for exclusion is shown in Figure .…”

Section: Resultsmentioning

confidence: 99%

Gastrografin reduces the need for additional surgery in postoperative small bowel obstruction patients without long tube insertion: A meta‐analysis

Ishizuka

Shibuya

Takagi

et al. 2018

Annals of Gastroent Surgery

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Background Small bowel obstruction (SBO) is a well‐known major postoperative complication requiring immediate diagnosis and treatment to avoid additional invasive surgical procedures. Water‐soluble contrast medium is often given not only for diagnosis but also for treatment. Although numerous studies have investigated the significance of this treatment, no consensus has yet been established regarding its indications and efficacy. Objective To explore whether Gastrografin can reduce the need for additional surgery in patients with postoperative SBO (PSBO). Methods We carried out a comprehensive electronic search of the literature (Cochrane Library, MEDLINE, PubMed and the Web of Science) up to February 2017 to identify studies that had shown efficacy of Gastrografin in reducing the need for surgery in patients with PSBO. To integrate the individual effects of Gastrografin, a meta‐analysis was done using random‐effects models to calculate the risk ratio (RR) and 95% confidence interval (CI), and heterogeneity was analyzed using I2 statistics. Results Twelve studies involving a total of 1153 patients diagnosed as having PSBO were included in this meta‐analysis. Not all patients received long‐tube insertion. Among 580 patients who received Gastrografin, 100 (17.2%) underwent surgery, whereas among 573 patients who did not receive Gastrografin, 143 (25.0%) underwent surgery. Giving Gastrografin significantly reduced the need for surgery (RR, 0.66; 95% CI, 0.46‐0.95; P = 0.02; I2 = 52%) in comparison with patients who did not receive Gastrografin. Conclusion Results of this meta‐analysis show that giving Gastrografin reduces the need for surgery in PSBO patients without long‐tube insertion.

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“…The authors used a cut-off point of 5 days after randomization for deciding to operate (14). Another randomized controlled trial by Rahmani et al on 84 patients with ASBO has shown that the need for surgical intervention in contrast to length of hospital stay was not significantly reduced in patients who were treated with gastrografin compared to the control ones using a cut-off point of 4 days (15). In a recent multicenter randomized controlled trial by Scotté et al, administration of gastrografin in 121 patients with ASBO has not been found to be associated with reduction in the rate of operation or length of hospital stay using cut-off point of 48 hours waiting compared to 121 patients in the control group (24% vs. 20% and 3.8 vs. 3.5 days, respectively) (11).…”

Section: Discussionmentioning

confidence: 97%

Therapeutic effect of gastrografin and predictors of operative intervention in patients with adhesive small bowel obstruction: A randomized controlled study

Khorshidi¹,

Majidi²,

Pirdehghan³

2019

Turk J Surg

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Objective: The study aimed to investigate the therapeutic effect of gastrografin for the conservative treatment of patients with adhesive small bowel obstruction (ASBO) and to identify the predictors of failure of conservative treatment in these patients. Material and Methods: A randomized controlled trial was conducted on 52 patients with the diagnosis of ASBO in 2016. 100 mL of Gastrografin and 100 mL of 0.9% saline solution were gavaged through the nasogastric tube in the case (n= 26) and control (n= 26) groups, respectively. Patients in the case group were subjected to plain abdominal X-Rays at 12, 24 and 48 hours after administration of gastrografin. Results: Fifty-two patients with a mean age of 57.6 ± 11.4 years (range 37-81), including 34 (65.4%) males were enrolled into the study. The number of patients who were successfully conservatively treated in the case group was 21 (80.8%), which was significantly higher than 13 (50%) in the control group (p= 0.04). Among these patients, mean hospital stay in the case group was 37.2 ± 5.5 hours (range 28-46), which was significantly shorter than 45.8 ± 9.2 hours (range 36-61) in the control group (p= 0.004). In multivariate analysis, more than one previous laparotomy was the only predictor of failure of conservative treatment (p< 0.001). Conclusion: Gastrografin may be associated with improvement of patients with ASBO. Lower number of previous laparotomies may be a predictor of successful conservative treatment of these patients.

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Prospective Evaluation of Oral Gastrografin® in the Management of Postoperative Adhesive Small Bowel Obstruction

Cited by 20 publications

References 15 publications

Diagnostic Value of Plain and Contrast Radiography, and Multi-slice Computed Tomography in Diagnosing Intestinal Obstruction in Different Locations

Diagnostic Value of Plain and Contrast Radiography, and Multi-slice Computed Tomography in Diagnosing Intestinal Obstruction in Different Locations

Gastrografin reduces the need for additional surgery in postoperative small bowel obstruction patients without long tube insertion: A meta‐analysis

Therapeutic effect of gastrografin and predictors of operative intervention in patients with adhesive small bowel obstruction: A randomized controlled study

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