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Evidence summaries

Oral Water Soluble Contrast for Adhesive Small Bowel Obstruction

Water-soluble contrast (Gastrografin®) is a good predictive test for non-operative resolution of adhesive small bowel obstruction but does not reduce the need for surgery. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 10 studies with a total of 845 subjects. The appearance of water-soluble contrast in the caecum on an abdominal radiograph within 24 hours of its administration predicted resolution of an adhesive small bowel obstruction with a pooled sensitivity of 0.97, specificity of 0.96. The area under the curve of the summary ROC was 0.98. In six randomised studies dealing with the therapeutic role of Gastrografin®, water-soluble contrast did not reduce the need for surgical intervention (OR 0.81, P = 0.3). Meta-analysis of four studies showed that water-soluble contrast reduced hospital stay compared with placebo (WMD = -1.83) P<0.001.

    References

    • Abbas S, Bissett IP, Parry BR. Oral water soluble contrast for the management of adhesive small bowel obstruction. Cochrane Database Syst Rev 2007 Jul 18;(3):CD004651. [PubMed]

Primary/Secondary Keywords