To study the efficacy of gastrografin in diagnosis of adhesive small bowel obstruction

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.