[Use of radiopaque markers for the diagnosis and management of small bowel obstruction].
Radiopaque markers were used for the diagnosis and management of small bowel obstruction (SBO) due to adhesion in 50 patients. Conservative therapy was begun after the patients received a capsule containing 20 radiopaque markers. The movement of the markers in the gastrointestinal tract was evaluated on X-P after 6, 12, 24, and 48 hours. On supine abdominal X-P, the abdomen was divided by a straight line connecting the right costophrenic angle and the left anterior superior iliac spine, thus defining an upper and lower abdominal segment. After 24 hours, the number of markers in the upper abdominal segment was 4.1 +/- 4.5 in 30 patients who recovered within 7 days, and 16.7 +/- 3.8 in 20 patients who required more than 7 days of conservative therapy (mean +/- SD). In cases requiring long-term management with conservative therapy, the markers in the small bowel were calculated on a daily basis using X-P. On day 7, there were more than 10 markers in the small bowel of 7 patients who underwent surgery. By using radiopaque markers, it was possible after 24 hours to differentiate patients with SBO who would need long-term management, and to determine the limits of conservative therapy and the timing for surgery.
Yokoyama
S
S
First Department of Surgery, Nippon Medical School Hospital, Tokyo, Japan.
Onda
M
M
Moriyama
Y
Y
Tanaka
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011859:Radiography; D000267:Tissue Adhesions / Q000150:complications
D003287:Contrast Media