Upper gastrointestinal contrast study in the management of small bowel obstruction--a prospective randomised study.
OBJECTIVE
To find out whether contrast radiography helps to resolve small bowel obstruction.


METHODS
Prospective randomised trial.


METHODS
University hospital, Norway.


METHODS
98 consecutive patients with symptoms of small bowel obstruction and a plain abdominal radiograph that confirmed the diagnosis.


METHODS
The patients were randomly allocated to receive a mixture of barium and sodium diatrizoate (Gastrografin) (n = 48) or not (n = 50). Both groups were followed up clinically and by repeated abdominal films.


METHODS
Non-operative resolution of small bowel obstruction; number of patients with strangulated bowel; bowel resections; mortality; complications; hospital stay; and time from admission to operation.


RESULTS
No significant differences were observed between the groups in the incidence of non-operative resolution (31/48 in contrast group, 35/50 in control group, OR: 0.89), strangulation obstruction (1/48 in contrast group, 4/50 in control group, OR: 0.24), bowel resection (3/48 in contrast group, 4/50 in control group, OR: 0.76), complications (8/48 in contrast group, 5/50 in control group, OR: 1.80), mortality (3/48 in contrast group, 1/50 in control group, OR: 3.26), and hospital stay (0-7 days: 34/48 in contrast group, 38/50 in control group, p = 0.95). The contrast group had a shorter interval between admission and operation than the control group (0-24 hours: 12/48 in contrast group, 3/50 in control group, p = 0.005).


CONCLUSIONS
The contrast examination did not contribute to the resolution of small bowel obstruction.
Fevang
B T
BT
Department of Surgery, University of Bergen, Norway.
Jensen
D
D
Fevang
J
J
Søndenaa
K
K
Ovrebø
K
K
Røkke
O
O
Gislasson
H
H
Svanes
K
K
Viste
A
A
D000328:Adult; D000368:Aged; D001466:Barium Sulfate; D003287:Contrast Media; D003973:Diatrizoate; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging* / Q000601:surgery; D007421:Intestine, Small / Q000000981:diagnostic imaging; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D000267:Tissue Adhesions / Q000000981:diagnostic imaging; D017211:Treatment Failure
D003287:Contrast Media; D003973:Diatrizoate; D001466:Barium Sulfate