Comment

When someone is admitted to hospital with suspected sub-acute obstruction post laparotomy there is controversy about the best way to manage them. Most of these patients settle on conservative management and repeated laparotomy is not necessary.

It is felt that those with partial obstruction are more likely to settle and this may be obvious from the observation that;

• Patient passes gas
• Gas is visible on plain radiology beyond the supposed site of obstruction

This paper provides a new stragegy in these patients; give them Gastrografin and this will quickly differentiate between those that will settle and those that need surgery. This avoids unecessary delay.