Contrast radiography in small intestinal obstruction, a valuable diagnostic tool?

Objective: To investigate the diagnostic and therapeutic potential of plain abdominal radiographs and contrast radiography in patients with suspected small intestinal obstruction. Design: Retrospective study. Setting: General hospital, Sweden. Material: 2357 sets of plain abdominal radiographic casenotes. Main outcome measures: Analysis of plain abdominal radiographs for small in testinal obstruction. Establishment of the time that subsequent contrast ra diography medium took to reach the caecum, and its success rate. Results: OF the 2357 plain abdominal films 1599 (68%) did not show small in testinal obstruction, 425 (18%) showed intermediate obstruction, and 333 (1 4%) showed small intestinal obstruction. The water-soluble contrast medium reached the colon in 394/591 (67%) of the cases with intermediate or comple te small intestinal obstruction. Although the contrast medium passed to the colon there was remaining abnormality with dilated small intestine in 71/2 12 (33%) of the cases with intermediate obstruction and in 95/143 (66%) of the small intestinal obstruction group. The time for the contrast medium to reach the colon was 3.4 hours in the normal group, 5.5 hours in the interm ediate group and 8.9 hours in the obstruction group. Conclusion: The plain abdominal radiographs seem to predict the success of follow-through examinations. Contrast radiography is safe and may have a th erapeutic potential in small intestinal obstruction.