Small bowel transit with radiopaque markers to localize intermittent smallbowel obstruction

Aim: In difficult diagnostic cases of partial small bowel obstruction, radi opaque, non-digestible markers were used to challenge and localize the site of obstruction. Material and Method: 32 patients (19 female, 13 male, 3-80 years) were examined. Each patient received 20 4-mm radiopaque markers ora lly. Abdominal radiographs were obtained at 4-8 h intervals. Mechanical obs truction was defined as the clustering of at least 3 markers for 4 hours or longer. The transit of radiopaque markers was compared to plain radiograph y, ultrasound, barium meal, computed tomography, enteroclysis and operative findings. Results: 18 of 32 patients showed small bower clustering suggest ive of obstruction. Diagnostic agreement was found in 12 of 14 cases with u ltrasound, in 7 of 13 cases with plain radiography and in 3 of 6 cases with enteroclysis. 13 of the 18 patients with clustering had surgery. All of th em (13/13) had adhesions with the need of resection. Conclusion: This inves tigation is an alternative diagnostic method for the decision between conse rvative and surgical treatment in cases of intermittent partial small bowel obstruction.