The role of contrast radiography in presumed bowel obstruction.
A retrospective review of 229 patients with a final diagnosis of small-bowel obstruction was undertaken to evaluate the role of contrast radiography in the management of their conditions. In 84 patients (37%) the clinical findings and plain abdominal roentgenograms were sufficient for diagnosis and subsequent management. Of the remaining 145 patients with equivocal findings, 27% had an upper gastrointestinal series, 29% a barium enema, and 44% had both. Useful information (complete obstruction, unobstructed passage of contrast, or diagnosis other than adhesional obstruction) was obtained from 86% of the radiographic studies. Three patients had negative contrast studies yet eventually underwent adhesiolysis (enterolysis) and were classified as false-negative. Two patients had evidence of high-grade obstruction yet had nonoperative resolution and were classified as false-positive. The mortality in the contrast group (7%) was not statistically different than that in the no-contrast group (7%). Contrast radiography is a safe and effective means of increasing diagnostic accuracy in patients with presumed small-bowel obstruction.
Riveron
F A
FA
Division of Trauma and Critical Care Surgery, Henry Ford Hospital, Detroit, MI 48202.
Obeid
F N
FN
Horst
H M
HM
Sorensen
V J
VJ
Bivins
B A
BA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate / Q000009:adverse effects; D002648:Child; D003287:Contrast Media / Q000009:adverse effects; D004733:Enema; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011859:Radiography
D003287:Contrast Media; D001466:Barium Sulfate