title: Gastrografin for uncomplicated adhesive small bowel obstruction in children.
abstract: OBJECTIVE
  The risk of bowel injury during surgery for small bowel obstruction (SBO) has generated interest in conservative treatment modalities. Few data are available on conservative Gastrografin treatment for SBO in children.
  
  
  METHODS
  We prospectively included patients with uncomplicated adhesive SBO managed at a pediatric center between March 2009 and September 2010. Patients who were unimproved after 48 h of conservative treatment received 50-100 ml of Gastrografin. If Gastrografin was seen in the cecum on the abdominal radiograph 4-6 h later, feeding was initiated and the patient was discharged on the same day. Each patient was matched to 2 controls on the number of previous SBO episodes. The primary outcome was length of hospital stay (>3 days), and the secondary outcome was time from admission to first feed (>2 days). Both were compared in the two groups using conditional logistic regression.
  
  
  RESULTS
  The 8 patients admitted for SBO were matched to 16 controls. Gastrografin administration was associated with significantly lower risks of staying in the hospital longer than 3 days (P < 0.10) and waiting more than 2 days before the first feed.
  
  
  CONCLUSIONS
  This preliminary study suggests that Gastrografin may be useful for managing adhesive SBO in children.
authors.affiliation: Department of General Pediatric Surgery, Robert Debré Hospital and Paris VII University, APHP, Robert Debré Hospital, 48, Boulevard Sérurier, 75019, Paris, France. arnaud.bonnard@rdb.aphp.fr
authors.forename: A
authors.initials: A
authors.lastname: Bonnard
authors.forename: J
authors.initials: J
authors.lastname: Kohaut
authors.forename: A
authors.initials: A
authors.lastname: Sieurin
authors.forename: N
authors.initials: N
authors.lastname: Belarbi
authors.forename: A
authors.initials: A
authors.lastname: El Ghoneimi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media / Q000008:administration & dosage / Q000493:pharmacokinetics; D003974:Diatrizoate Meglumine / Q000008:administration & dosage* / Q000493:pharmacokinetics; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D007415:Intestinal Obstruction / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D007421:Intestine, Small; D007902:Length of Stay / Q000639:trends; D008297:Male; D011446:Prospective Studies; D011860:Radiography, Abdominal; D000267:Tissue Adhesions / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D003974:Diatrizoate Meglumine