Methods: Eighty-three patients admitted between Feburary 2000 and November 2001 with 90 episodes of symptoms and signs suggestive of postoperative adhesive SBO were randomized into two groups, a control group and a Gastrografin group. Patients in the control group were treated conservatively. If symptoms of stringulation developed or the obstruciton did not resolbe spontaneously after 4-5 days, a lapartomy was performed. Patients in the Gastrograffin group received 100 ml Gastrografin. Those in whom the contrast medium reached the colon in 24 h were considered to have partial SBO, and were fed orally. If Gastrografin failed to reach the colon and the patient did not improve in the following 24 h a laparotomy was performed.
Results: Conservative treatment was successful in 77 episodes (85.6 per cent) and 13 (14.4 per cent) required operation. Among patient treated conservatively, hosptial stay was shorter in the Gastrografin group (P 0.001). All patients in whom contrast medium reached the colon tolerated an early oral diet. Gastrografin did not reduce the need for operation (P 1.000). No patient died in either group.
Conclusion: Oral Gastrografin helps in the management of patients with adhesive SBO and allows a shorter hosptial stay.