Therapeutic role of oral water soluble iodinated contrast agent in postoperative small bowel obstruction

Kumar P, Kaman L, Singh G, Singh R
Correspondence: Dr Lileswar Kaman, kamanlil@yahoo.com

ABSTRACT
Introduction Nonoperative measures using an oral water soluble contrast agent is a significant development in the management of patients with postoperative small bowel obstruction.
Methods In this prospective randomised trial, patients were randomised into two groups: Group A patients were given an oral water soluble contrast agent and Group B patients were managed conventionally. Surgery was performed as and when indicated. The end-points of the study were to evaluate the time interval between admission and relief of obstruction, the length of hospital stay and the need for surgery.
Results Of a total of 41 patients, 21 were in Group A and 20 were in Group B. The mean age of Group A patients was 40.48 +/- 14.96 years and it was 43.40 +/- 16.33 years for Group B patients (p-value is 0.553). There were 17 males and four females in Group A, and 14 males and six females in Group B (p-value is 0.441). In Group A, 14 patients had relief of obstruction after administration of the contrast material, and the mean time for relief of obstruction was 7.47 hours. In Group B, 18 patients had relief of obstruction and the time interval was 35.20 hours (p-value is less than 0.001). The mean length of hospital stay was 3.43 +/- 1.08 days for Group A and 5.33 +/- 2.95 days for Group B (p-value is 0.029). Seven patients in Group A and two in Group B were operated on (p-value is 0.071).
Conclusion Administration of an oral water soluble contrast agent in postoperative small bowel obstruction helps in the earlier resolution of the obstruction and decreases the length of hospital stay.

Keywords: intestinal obstruction, nonoperative management of bowel obstruction, postoperative small bowel obstruction, small bowel obstruction
Singapore Med J 2009; 50(4): 360-364