Role of Gastrografin in Adhesive Intestinal Obstruction

Abstract

Objective: To determine the role of gastrografin in adhesive intestinal obstruction. Study Design: This is an observational study. Setting: Study carried out at General Surgery Department, Liaquat University of Medical and Health Sciences Jamshoro and Shaheed Benazir Bhutto Medical College, Lyari Karachi, from January 2020 to July 2021. Material & Method: Patients having clinical and radiological signs evidence of adhesive bowel obstruction over the age of 18 years were selected for the study. One hundred milliliters of gastrografin were given via nasogastric tube and its transit was followed by serial abdominal radiographs and fluoroscopy. Results: In the time of 1 and half years, we received 53 patients with adhesive intestinal obstruction. It included 54.7% (n= 29) males and 45.2% (n=24) females with a mean age of 61 years. Out of 53 patients, 46 patients had a single previous abdominal surgery. After complete examination and investigations emergency laparotomy was performed in 15% (n=8) patients. Hence, out of total 53 patients, 27 patients fit into our criteria for gastrografin meal and follow through. Fluoroscopy revealed a partial obstruction in 19 patients and complete obstruction in 8 patients. After gastrografin follow through obstruction was relieved in 17 patients within the meantime of 63 hours (range 20-78h). Conclusion: In our study, gastrografin is found to be of great diagnostic and therapeutic value, with fewer adverse effects. It also reduces the need for surgery, hence decreasing the financial burden of operative treatment. In Pakistan, its use is still limited because of a lack of equipment, expertise, and radiological imaging facilit.