CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ | |
Journals - Article | |
Česky / Czech version | Čes. Radiol., 54, 2000, No. 5, p. 305 - 309. |
The Value of Hyperosmolar Water-soluble Contrast Follow-up Study in
Suspected Acute Small Bowel Obstruction Poulová M. 1 , Neuwirth J. 1 , Girsa D. 1 , Hoch J. 2 , Suldovská H. 3 , Robová H. 4 Klinika zobrazovacích metod 2. LF UK, FNsP v Motole, Praha, 1 |
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Summary: Authors reviewed water-soluble contrast follow-up studies in 23 patients with suspected acute small
bowel obstruction with the aim to determine the value of this method. They assessed whether
clinical management, patients’ outcomes and medical care costs are influenced, and they propose
a standard technique of the examination. They compared radiological findings of all patients with
the clinical course in succeeding period and in 9 patients also their findings on laparotomy.
Complete small bowel obstruction was ruled out by radiology in 14 of 23 patients (61 %), conservative
treatment was continued in 13 of 23 patients (57 %). In 1 case radiology suggested a complete small
bowel obstruction but the patient’s improved condition was a more reliable indicator for non-ope-
rative treatment. In 2 patients without radiological signs of complete small bowel obstruction
laparotomy was performed due to obstruction of the colon. In both these patients with non-operable
gynaecological tumours colostomy was made. One patient with suspected small bowel obstruction
was operated during the following hospital stay for paraoesophageal hernia which was discovered
by contrast examination. As most important authors consider that in 4 of 20 patients (20 %) not only
a complete small bowel obstruction was ruled out but also that they were free of all obstructive
symptoms or passed their first stool immediately after the water-soluble contrast examination.
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