Gastrografin® Use and Its Benefits in Small Bowel Obstruction - A Single-Center Retrospective Study.

Abstract

Background: Gastrografin® (GG) is a water-soluble contrast agent. Besides its role in diagnosing small bowel obstruction (SBO), its effectiveness in treating adhesive small bowel obstruction (ASBO) has been suggested.

Aim: A retrospective study was performed at our institution to observe whether patients receiving GG benefited from the intervention compared to patients receiving standard treatment of SBO.

Methods: Administration of GG was the surgeon's decision, as was the decision for operative treatment. No treatment protocols were used at the department regarding GG use. The observed variables were length of hospital stay (LoHS), operative rate, and mortality rate.

Results: Results of our study confirmed a substantial diagnostic value of GG challenge; passage of GG to the large bowel indicates successful conservative treatment of SBO. We observed that patients receiving GG (GG+) at our department did not have a significantly lower LoHS or mortality rate than those not receiving GG (GG-). However, GG+ did have a lower mean LoHS and a lower mean mortality rate than GG- group. The GG+ group displayed a significantly lower operative rate. Based on the design of our study, this cannot be attributed to the therapeutic effect of GG but rather to the selective treatment of patients.

Conclusion: The GG challenge is a solid diagnostic tool, indicating a successful resolution of SBO if the passage of the contrast to the large bowel can be demonstrated. Although our study results point towards its positive effect, we cannot confirm the therapeutic function of GG due to probable treatment bias in severely affected patients.