Bt. Fevang et al., Upper gastrointestinal contrast study in the management of small bowel obstruction - a prospective randomised study, EURO J SURG, 166(1), 2000, pp. 39-43
Objective: To find out whether contrast radiography helps to resolve small
bowel obstruction.
Design: Prospective randomised trial.
Setting: University hospital, Norway.
Subjects: 98 consecutive patients with symptoms of small bowel obstruction
and a plain abdominal radiograph that confirmed the diagnosis.
Interventions: The patients were randomly allocated to receive a mixture of
barium and sodium diatrizoate (Gastrografin) (n = 48) or not (n = 50). Bot
h groups were followed up clinically and by repeated abdominal films.
Main outcome measures: Non-operative resolution of small bower obstruction;
number of patients with strangulated bower; bowel resections; mortality; c
omplications; hospital st;ly; and time from admission to operation.
Results: No significant differences were observed between the groups in the
incidence of non-operative resolution (31/48 in contrast group, 35/50 in c
ontrol group, OR: 0.89), strangulation obstruction (1/48 in contrast group,
4/50 in control group, OR: 0.24), bower resection (3/48 in contrast group,
4/50 in control group, OR: 0.76), complications (8/48 in contrast group, 5
/50 in control group, OR: 1.80), mortality (3/48 in contrast group, 1/50 in
control group, OR: 3.26), and hospital stay (0-7 days: 34/48 in contrast g
roup, 38/50 in control group, p = 0.95). The contrast group had a shorter i
nterval between admission and operation than the control group (0-24 hours:
12/48 in contrast group, 3/50 in control group, p = 0.005).
Conclusion: The contrast examination did not contribute to the resolution o
f small bowel obstruction.