title: Evaluation of a water-soluble contrast agent for the conservative management of adhesive small bowel obstruction in pediatric patients.
abstract: OBJECTIVE
  The diagnostic and therapeutic benefits of a commercial water-soluble contrast agent (Gastrografin) in pediatric patients with adhesive small-bowel obstruction (ASBO) are controversial. The aim of this study was to assess the therapeutic value of Gastrografin in the management of ASBO in children after unsuccessful conservative treatment.
  
  
  METHODS
  Medical records from patients with uncomplicated ASBO managed at Cathay General Hospital, Taipei, Taiwan between January 1996 and December 2011 were retrospectively reviewed. All children ≤18 years of age with clinical evidence of ASBO were managed conservative treatment, unless there was suspicion of strangulation. Patients who did not improve after 48 hours of conservative treatment were administered Gastrografin.
  
  
  RESULTS
  Twenty-four patients with 33 episodes of ASBO were analyzed. Of those, there were 19 episodes of ASBO that failed to respond to the initial conservative management, and 16 (84%) responded well to Gastrografin administration thereby abrogating the need for surgical intervention. There were neither complications nor mortality that could be attributed to the use of Gastrografin.
  
  
  CONCLUSIONS
  This preliminary study suggested that the use of a water-soluble contrast agent in ASBO is safe in children and useful for managing ASBO, particularly in reducing the need for surgery when conservative treatment fails. However, larger prospective studies would be needed to confirm these results.
authors.affiliation: Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Chee-Yew
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan; Department of Pediatrics, Tri-Service General Hospital Songshan Branch, Taipei, Taiwan.
authors.forename: Min-Hsuan
authors.initials: MH
authors.lastname: Hung
authors.affiliation: Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan; School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan. Electronic address: LHLINLH@yahoo.com.tw.
authors.forename: Lung-Huang
authors.initials: LH
authors.lastname: Lin
authors.affiliation: Department of Surgery, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Der-Fang
authors.initials: DF
authors.lastname: Chen
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media / Q000627:therapeutic use*; D003974:Diatrizoate Meglumine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007415:Intestinal Obstruction / Q000188:drug therapy* / Q000209:etiology; D007421:Intestine, Small; D008297:Male; D011183:Postoperative Complications / Q000188:drug therapy*; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000150:complications; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D003974:Diatrizoate Meglumine
keywords: Adhesive small bowel obstruction; Children; Gastrografin®; Water-soluble contrast agent