Document Detail


Water-soluble contrast material has no therapeutic effect on postoperative small-bowel obstruction: results of a prospective, randomized clinical trial.
MedLine Citation:
PMID:  8619455     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hyperosmotic water-soluble contrast materials have been fo und to be helpful diagnostic tools in postoperative small-bowel obstruction (POSBO); however, their therapeutic value remains controversial. PATIENTS AND METHODS: A prospective, randomized clinical study was conducted to examine the use of meglumine ioxitalamate as a supplement to the standard conservative treatment of POSBO. Patients with POSBO (n = 50) suitable for a conservative approach were randomized to receive standard conservative treatment with (n = 25) or without (n = 25) the addition of 100 mL of meglumine ioxitalamate via the nasogastric tube (patients with diffuse carcinomatosis and early POSBO were excluded). Both groups were compared for resolution of obstruction, need for surgical relief of obstruction, and complications. RESULTS: Seven (14%) patients required surgery: 3 in the contrast material group and 4 in the control group (P = not significant [NA]. Resolution of symptoms was achieved in nonsurgical patients within an average of 25.7 hours in the contrast material group and 28.7 hours in the control group (P = NS). There was no mortality in this study. In 2 (4%) patients (1 in each group), strangulated bowel was found during surgery, but only the 1 (2%) patient in the contrast material group required bowel resection. No difference was found in the length of hospital stay or rate of complications. There were no complications that could be attributed to the use of the contrast material itself. CONCLUSIONS: Although water-soluble contrast material is a safe and useful diagnostic tool, it offers no advantage as a supplement to the usual conservative treatment of POSBO.
Authors:
E Feigin; D Seror; A Szold; M Carmon; T M Allweis; A Nissan; E Gross; A Vromen; H R Freund
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American journal of surgery     Volume:  171     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  1996 Feb 
Date Detail:
Created Date:  1996-06-12     Completed Date:  1996-06-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  227-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Hadassah University Hospital, Jerusalem, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Contrast Media / therapeutic use*
Humans
Intestinal Obstruction / etiology*,  therapy*
Iothalamate Meglumine / therapeutic use*
Middle Aged
Postoperative Complications / therapy*
Prospective Studies
Suction
Treatment Failure
Chemical
Reg. No./Substance:
0/Contrast Media; 13087-53-1/Iothalamate Meglumine; 29288-99-1/meglumine ioxithalamate
Comments/Corrections
Comment In:
Am J Surg. 1997 Feb;173(2):148-9   [PMID:  9074385 ]
Am J Surg. 1997 May;173(5):455-7   [PMID:  9168092 ]

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