title: Role of water soluble contrast agents in assigning patients to a non-operative course in adhesive small bowel obstruction.
abstract: OBJECTIVE
  Adhesive small bowel obstruction (SBO) is a common surgical emergency. It is estimated that at least 60% of SBO are due to post-operative adhesions. Water soluble contrast agents (gastrografin) have been used to identify patients who might be treated non-operatively. This study aims to determine the role of gastrografin in adhesive intestinal obstruction patients.
  
  
  METHODS
  In this prospective study, 27 patients admitted between 1(st) August 2004 and 1(st) July 2006 with clinical signs suggestive of postoperative adhesive SBO met the inclusion criteria. After intravenous hydration, nasogastric tube insertion and complete suctioning of the gastric fluid, 100 ml of gastrograsfin was given and plain abdominal radiography was taken 6 hours and 24 hours if the contrast is not seen in the colon. Those in whom the contrast reached the colon in 24 hours were considered to have partial SBO and started oral intake. If gastrografin failed to reach the colon in 24 hours and the patient did not improve in the following 24 hours, laparotomy was performed.
  
  
  RESULTS
  Conservative treatment was successful in 31 cases (91%) and 3 (9%) required operation. Patients treated conservatively had short hospital stay (mean=4 days) and tolerated oral feeding with no morbidity or mortality.
  
  
  CONCLUSIONS
  Oral gastrografin helps in the management of patients with postoperative adhesive SBO.
authors.affiliation: Department of Surgery, King Fahd Hospital of the University, College of Medicine, Dammam University, Kingdom of Saudi Arabia, P.O. Box 40081, Al Khobar 31952, Saudi Arabia.
authors.forename: Hamid Ai
authors.initials: HA
authors.lastname: Wadani
authors.forename: Naif Ibrahim
authors.initials: NI
authors.lastname: Al Awad
authors.forename: Khairi Ahmed
authors.initials: KA
authors.lastname: Hassan
authors.forename: Hazem Mohamed
authors.initials: HM
authors.lastname: Zakaria
authors.forename: Faten O
authors.initials: FO
authors.lastname: Alaqeel