[Gastrografin challenge test for the management of subileus in children].
BACKGROUND
The appearance of gastrografin in colon within 6 hours after gastric administration rules out the need of surgery in abdominal subileus. This diagnostic management is not routinely applied in children. We present a one-year experience from the department of pediatric surgery.


METHODS
Between April 2006 and September 2007 children with symptoms of ileus without clear indications for surgery were subjected to the study. Naso-gastric tube was inserted and 20-100 cc of gastrografin was administered. Abdominal radiograph was taken within 4-6 hours. The presence of contrast in colon allowed for conservative management. All remaining children were subjected to surgery. Newborns and children with intussusception or incarcerated hernia were ruled out of the study.


RESULTS
The study was implemented in 8 girls and 7 boys ranking in the age between 1 and 17 (mean 11) years. Thirteen children had postoperative obstruction (8 after appendectomy, 5 after other laparotomy). Two children (with Crohn disease and Schoenlein-Henoch purpura) were not operated before. Four children without appearance of contrast in colon were operated. None of the remaining eleven children required surgical intervention.


CONCLUSIONS
This management is safe and effective. It brings forward decision for surgery and shortens observation in children who don't require surgical intervention.
Górecki
Wojciech
W
Klinika Chirurgii Dzieciecej, Uniwersytet Jagielloński Collegium Medicum w Krakowie. migoreck@cyf-kr.edu.pl
Krysta
Mirosław
M
Bysiek
Adam
A
Wojciechowski
Piotr
P
Wyrobek
Lukasz
L
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D003974:Diatrizoate Meglumine; D005260:Female; D006801:Humans; D045823:Ileus / Q000000981:diagnostic imaging* / Q000601:surgery*; D007223:Infant; D008297:Male; D011859:Radiography
D003287:Contrast Media; D003974:Diatrizoate Meglumine