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ABSTRACT
Background: Small bowel obstruction(SBO) is a common condition in surgical wards and have prolonged hospital stay due to inappropriate diagnosis. Many studies have shown gastrografin to be highly effective in diagnosing bowel obstruction and differentiate between mechanical and functional obstruction, hence take proper early decision regarding further management.Gastrografin has both diagnostic and therapeutic value.
Methodology: Patients with subacute SBO presenting to M.S.Ramaiah Medical College Teaching Hospital Bangalore, will be taken for study.This is a comparitive study between a group of 25 patients who presented with SBO previously and did not receive gastrografin and other group of 25 patients, who present now and receive gastrografin and serial abdominal X-rays taken between 4 to 24 hrs.
Results: Out of the 25 patients in group A(cases),7 patients (28.0%) required surgery at the end of 24 hours after admission; while 18 patients (72.0%) tolerated the oral feeds. Out of 25 patients in group B (control),11 patients(44.0%)improved with conservative treatment within 48 hours of admission.However,14 patients(56.0%) from group B were operated within 48 hours of admission because of increasing signs of obstruction.There were 25 patients in group A.The radiographic contrast reached the caecum within 24 hours in 18 out of these 25 patients and oral feeds were started.All of these 18 patients tolerated the feeds well and were subsequently discharged.The 7 patients in whom the radiographic contrast did not reach the caecum within 24 hours were operated.Therefore Gastrografin had a Sensitivity value of 72% and Specificity value of 56%.
Conclusion: The uses Gastrografin in adhesive SBO are it is efficacious in diagnosing partial and total small bowel obstruction, avoids surgery,probable therapeutic action,accurate and early diagnosis.
Keywords: Adhesive SBO, Gastrografin, Diagnosis, Therapy
INTRODUCTION
Small bowel obstruction is defined as partial or complete interference with the passage of stool distally in the small intestine1. A better understanding of the pathophysiology of bowel obstruction and the use of isotonic fluid resuscitation, intestinal tube decompression and antibiotics have greatly reduced the mortality rate in patients with mechanical small bowel obstruction2There need to be an emphasis to diagnose the condition accurately. Many studies have shown gastrografin to be highly effective in diagnosing bowel obstruction and differentiate between mechanical and functional obstruction3, hence take proper early decision regarding further management4. It has also...