title: Comparison of Urografin versus standard therapy in postoperative small bowel obstruction.
abstract: Water-soluble contrast media (Urografin) cause redistribution of intravascular and extracellular fluid into intestinal lumen due to their hyperosmolarity. As a consequence, these media decrease intestinal wall edema and act as a direct stimulant to intestinal peristalsis. In this prospective study, we aimed to examine objectively the therapeutic role and ability of Urografin in patients with postoperative small bowel obstruction for whom failed to respond to conservative treatment. Three hundred and seventeen patients with postoperative small bowel obstruction due to intraperitoneal adhesions were included prospectively in this study. In the Urografin group, 40 mL Urografin diluted in 40 mL distilled water was administered through the nasogastric tube. No contrast media were administered in the control group, but the patients were decompressed via a nasogastric tube continuously. The number of obstruction episode in 317 patients was 338. In total, 199 patients were in the Urografin group, and 118 patients were in the control group. In the Urografin group, 178 (89.4%) patients responded successfully to the treatment, but 21 (11.6%) patients underwent surgical operation. Intensive intraabdominal adhesions and obstructing fibrous bands were observed and repaired in 15 (71.4%) patients at the operation, while 6 patients underwent segmental small intestine resection in control group, conventional management was successful in only 89 (75.4%) patients, and the remaining 29 (24.6%) patients underwent surgical intervention. In conclusion, it was suggested that in patients with intestinal obstruction due to postoperative intra-abdominal adhesion, water-soluble contrast media such as Urografin may be safely administered via a nasogastric tube or oral route and may decrease the need for surgical operation; furthermore, they may help the physician to operate the patients who needs surgery as early as possible.
authors.affiliation: Department of General Surgery, Gulhane Military Medical Academy, Ankara, Turkey. gyagci@gata.edu.tr
authors.forename: Gokhan
authors.initials: G
authors.lastname: Yagci
authors.forename: Nihat
authors.initials: N
authors.lastname: Kaymakcioglu
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Can
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Peker
authors.forename: Sadettin
authors.initials: S
authors.lastname: Cetiner
authors.forename: Turgut
authors.initials: T
authors.lastname: Tufan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000627:therapeutic use*; D003974:Diatrizoate Meglumine / Q000627:therapeutic use*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000628:therapy*; D007421:Intestine, Small / Q000000981:diagnostic imaging; D007441:Intubation, Gastrointestinal; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011859:Radiography; D000267:Tissue Adhesions / Q000209:etiology / Q000628:therapy
chemical_list: D003287:Contrast Media; D003974:Diatrizoate Meglumine