Small bowel obstruction and the gastrografin challenge
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The “gastrografin challenge” has been used for decades in the evaluation of small bowel obstruction (SBO). This type of study involves enteric administration of a water-soluble contrast followed by serial abdominal radiographs. While its diagnostic role is well established, its therapeutic role remains controversial. Following an algorithm for gastrografin challenge cases can help with interpretation. An understanding of the appearance of diluted contrast in the small bowel, the concentrating effect of contrast in the colon, and knowledge of surgical history and anatomy is paramount for diagnosis. In this article, we review the approach to acute SBO and the use of gastrografin along with reviewing image interpretation of cases of partial and complete SBO. Gastrografin use in adynamic ileus along with other potential future uses is also discussed.
KeywordsGastrografin Small bowel obstruction Adhesions
Compliance with ethical standards
No funding was received for this study.
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
Statement of informed consent was not applicable since the manuscript does not contain any patient data.
- 3.Epstein BS (1955) Nonabsorbable water-soluble contrast mediums: Their use in diagnosis of intestinal obstruction. J Am Med Assoc 165:2–4Google Scholar
- 8.Scotté M, Mauvais F, Bubenheim M, Cossé C, Suaud L, Savoye-Collet C, et al. (2017) Use of water-soluble contrast medium (gastrografin) does not decrease the need for operative intervention nor the duration of hospital stay in uncomplicated acute adhesive small bowel obstruction? A multicenter, randomized, clinical trial (Adhesive Small. Surgery (United States) pp. 1315–1325. https://doi.org/10.1016/j.surg.2016.11.026 CrossRefGoogle Scholar
- 9.Zielinski MD, Haddad NN, Cullinane DC, et al. (2017) Multi-institutional, prospective, observational study comparing the Gastrografin challenge versus standard treatment in adhesive small bowel obstruction. J Trauma Acute Care Surg 83:47–54. https://doi.org/10.1097/TA.0000000000001499 CrossRefPubMedGoogle Scholar
- 11.Choi H-K, Chu K-W, Law W-L (2002) Therapeutic value of gastrografin in adhesive small bowel obstruction after unsuccessful conservative treatment: a prospective randomized trial. Ann Surg 236:1–6. https://doi.org/10.1097/01.SLA.0000018563.62559.95 CrossRefPubMedPubMedCentralGoogle Scholar
- 12.Jaffar S, Qureshi S, Channa A, Maher M (2012) Role of orally administered gastrografin in small bowel obstruction after unsuccessful conservative treatment. Pakistan J Med Sci 28:936–939Google Scholar
- 13.Bracco Imaging. Gastrografin Safety Data Sheet. (2017) http://imaging.bracco.com/sites/braccoimaging.com/files/technica_sheet_pdf/us-en-2016-07-15-sds-Gastrografin.pdf