Postoperative ileus on a gynecologic oncology service--do abdominal X-rays have a role?
OBJECTIVE
The objective was to estimate the role of abdominal radiographs in the management of the patient with gastrointestinal dysfunction in the early postoperative period following intra-abdominal gynecologic surgery.


METHODS
Hospital records were reviewed for 84 patients from the gynecologic oncology service having a clinical diagnosis of either ileus or bowel obstruction immediately after intra-abdominal gynecologic surgery. Patient history, clinical signs and symptoms, findings of plain radiographs, and clinical course were studied to determine whether plain abdominal radiographs were useful in the management of these patients.


RESULTS
At least one set of abdominal X-rays was obtained for 56 (66.7%) patients, of which 24 (42.9%) were considered radiographically diagnostic. A lower preoperative American Society of Anesthesiologists (ASA) physical status score correlated with a greater likelihood of having abdominal films (P = 0.005). No single clinical finding correlated with either the decision to obtain films or X-ray diagnosis of ileus or bowel obstruction. Use of any nonsurgical treatment modality was not significantly different for patients who had films versus those who did not. Mean length of hospital stay was significantly prolonged for patients who had abdominal X-rays. Seven patients were subjected to reoperation; however, no association was found between X-ray diagnosis of ileus or bowel obstruction and the need for reoperation.


CONCLUSIONS
Plain abdominal radiographs have little clinical utility in the evaluation of patients with gastrointestinal dysfunction in the early postoperative period following intra-abdominal gynecologic surgery. Diagnostic studies such as CT scanning or a GI contrast study may be more helpful in the management of these patients.
Heinberg
Eric M
EM
Department of Obstetrics and Gynecology, Ochsner Clinic Foundation, New Orleans, LA 70121, USA.
Finan
Michael A
MA
Chambers
Richard B
RB
Bazzett
Lisa B
LB
Kline
Richard C
RC
D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011860:Radiography, Abdominal