What is the role of water-soluble oral contrast medium (WSCM) in the treatment of small-bowel obstruction (SBO)?

Updated: Apr 28, 2017
  • Author: Mityanand Ramnarine, MD, FACEP; Chief Editor: Steven C Dronen, MD, FAAEM  more...
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Studies have evaluated the use of WSCM as a tool in the management of SBO and as a predictive tool for nonoperative resolution of adhesive SBO. Although it does not cause resolution of the SBO, WSCM may reduce the hospital stay in patients not requiring surgery.

However, a more recent systematic review that analyzed retrospective data (2006-2009) from 242 patients in 10 studies with uncomplicated acute adhesive SBO indicated no benefit of administering gastrografin compared with saline solution in reducing the need for surgical intervention (24% vs 20%, respectively) or bowel resection (8% and 4%). Results were similar for both groups with respect to the time interval between the initial CT scan and surgery, as well as the time interval between oral refeeding and discharge. [28] The sole potential risk factor for failure of nonoperative management was age.

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