title: Efficacy of intestinal decompression with long nasointestinal tube and selective contrast radiography in the treatment of small bowel obstruction in elderly patients.
abstract: BACKGROUND
  This study's aim was to assess the efficacy of intestinal decompression with long tube and selective intestinal radiography in the diagnosis and treatment of small bowel obstruction (SBO) in elderly patients.
  
  
  METHODS
  Thirty-two elderly patients with SBO received intestinal decompression with a 300-cm long nasointestinal tube inserted into upper jejunum under radiographic control. The long tube was passed into the proximal part of obstruction or the proximal end of ileum driven by intestinal peristalsis. Selective contrast radiography was done using direct injection of double-contrast medium consisting of 20-100 mL of 76% gastrografin and 50-200 mL of air. The dynamic and multi-position radiographic observation was conducted.
  
  
  RESULTS
  Intubation was successful in all 32 patients. SBO resolution was successful in 29/32 (90.6%) patients. The 3 remaining patients proceeded to undergo surgery. Radiographic findings showed no obvious abnormalities in 25/32 (78.1%) patients, adhesive SBO in 6/32 (18.6%), and metastatic intestinal tumor in 1/32 (3.1%) patient.
  
  
  CONCLUSIONS
  Decompression using long tube can quickly and effectively relieve obstructive symptoms in elderly patients, and help to avoid emergency surgery and to resolve obstruction. Concurrent contrast radiography is helpful to verify the location and degree of obstruction, and to reveal the cause of the obstruction.
authors.affiliation: Department of Radiology, Xuzhou Hospital, Xuzhou Central Hospital, Southeast University, Xuzhou, Jiangsu Province, China - lidechun7878@sina.com.
authors.forename: De C
authors.initials: de C
authors.lastname: Li
authors.forename: Rui H
authors.initials: RH
authors.lastname: Li
authors.forename: Qingzhong
authors.initials: Q
authors.lastname: Tian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D057785:Catheters; D003287:Contrast Media / Q000008:administration & dosage*; D019299:Decompression, Surgical / Q000379:methods; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy*; D007421:Intestine, Small / Q000000981:diagnostic imaging; D007441:Intubation, Gastrointestinal / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D009666:Nose; D011860:Radiography, Abdominal / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media