Title: Role of Water Soluble Contrast in Management of Post- Operative Adhesive Small Bowel Obstruction
Authors: Dr Ashutosh Silodia M.S., Dr Chandan Tiwari M.S., Dr Anurag Dubey M.S.
DOI: https://dx.doi.org/10.18535/jmscr/v6i2.66
Abstract
This study “Role of water soluble contrast in management of post-operative small bowel obstruction” was conducted in Department of surgery N.S.C.B. medical college between August 2013 to October 2014 to assess the therapeutic role of water soluble contrast in post operative adhesion induced small bowel obstruction in relieving obstruction. Total of 17 patients were included in study in age group 30-50yrs with majority of males. These patients were having main complaints of abdominal pain, distention vomiting, not passing flatus and motion. During diagnostic tests X-ray abdomen showed multiple bowel loops and air fluid levels.13 patients were given gastrograffin and continued in conservative management however 4 were referred for surgery. In majority of patients (46%) Ryle’s tube aspiration stopped within 24 hrs and bowel sound reappeared in first 2 days of admission (76%) on giving gastrograffin. Also 65% passed flatus and motion within 24 hrs however mean hospital stay was 8.85 days in gastrograffin treated patients compared to 16.5 days in surgically treated patients. Thus by result of this study it can be emphasised that Gastrograffin which is used as contrast media for CT scan purpose as diagnostic support can also be tried as therapeutic agent in patients with small bowel obstruction due to post-operative adhesions and have significant outcome both clinically and also statistically. Hence it can be recommended that with a specific selection criteria for patients and high range of vigilance and suspicion Gastrograffin can be used therapeutically and safely in patients of small bowel obstruction specifically due to post op adhesions to get relief from obstruction and with an advantage that if it fails then CT scan can use this dose as contrast for imaging and confirm obstruction and can be proceeded for surgery as per need.
