[Use of Gastrografin(®) in the management of adhesion intestinal obstruction].

BACKGROUND Adhesions are the most important cause of intestinal obstruction. Approximately 25% of surgical admissions for acute abdominal conditions are due to intestinal obstruction. Better diagnostic and treatment methods of intestinal obstruction could potentially reduce mortality rate to 5-10%. Gastrografin(®) could contribute to this achieve this. AIM To present a protocol to treat adhesion intestinal obstruction with Gastrografin(®) that is safe, and allows shorter hospital stays and shorter time between admission and surgery. MATERIAL AND METHODS All patients with adhesion intestinal obstruction without symptoms of strangulation were treated with Gastrografin(®), intravenous fluids and nasogastric tube. Those in whom contrast reach the colon in 8, 12 or 24hours were considered to have partial obstruction, and were fed orally. If Gastrografin(®) failed in the following 24hours, a laparotomy was performed. RESULTS Out of a total of 211 episodes (164 patients), 170 episodes received contrast and in 142 cases Gastrografin(®) reached the colon (104 episodes at 8h, 11 at 12h, and 27 at 24h). A laparotomy was required in 28 patients because of failed treatment, and in another 5 for other causes. CONCLUSIONS A management protocol for adhesion intestinal obstruction with Gastrografin(®) is safe, reduces morbidity and mortality, and leads to a shorter hospital stay.