Title: Evaluation of efficacy of gastrografin in adhesive small bowel obstruction
Authors: Dr Mukul Gupta, Dr Kalpana Gupta
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.152
Abstract
Background: Various conservative means of managing ASBO have been reported, including nasogastric tube suction and fluid resuscitation, and administration of water-soluble contrast agents, such as gastrografin, which may also serve to determine the need for surgery. In adults, conservative treatment of ASBO is frequently used and has been found to be effective in a relatively large, but somewhat variable (approximately 40% to 70%), proportion of cases.
Aim: To evaluate the effectiveness of gastrografin in adhesive small bowel obstruction.
Materials and Method: The present study was conducted in the Department of General Surgery of the medical institution. For the study we selected a total of 80 patients diagnosed for ASBO. Patients were randomized to receive Gastrografin (Group 1) or Placebo (Group 2) with 40 patients in each group. In patients with of Group 1, 60 ml of Gastrografin admixed with 40 ml of normal saline was administered after two hours of active stomach decompression through nasogastric tube. Patients of both groups were closely monitored by repeated clinical examination without further radiological examination. The criteria for discharge were patient free from obstructive symptoms and tolerating normal diet.
Results: Out of the 35 patients in Group 1, 28 patients received treatment of ASBO with conservative management with surgery required in only 7 patients. SBO was resolved within first twenty four hours of admission in 26 patients of Group 1 and 13 patients of Group 2 (p<0.05). Patients who were managed conservatively in Group A and Group B had a mean hospital stay of 5.2 + 1.2 days and 8.8 + 1.9 days respectively.
Conclusion: The administration of oral water soluble agent in cases of ASBO has a definite therapeutic role in their management.
Keywords: ASBO, gastrograffin, conservative treatment, surgical treatment.
