WP4.11 - Oral Gastrograffin Usage in Adhesive Small Bowel Obstruction: a re-audit

Abstract Aim to establish the successful usage of oral gastrograffin in patients presenting with adhesive small bowel obstruction (SBO). Methods This is a retrospective follow-up study, using a combined data collected from two NHS Trusts, from July 2022 to January 2024. Patients presented with adhesive SBO were included in this study, who were given 100 ml of oral gastrograffin after diagnosis for SBO. Patients were arranged to have plain abdominal x-ray approximately 8-hours post-gastrograffin drinks/or infusion via nasogastric (NG) tube to ascertain if oral contrast had passed the transition point, identified on initial abdominal CT scan. Patients were then reviewed for their symptomatic relief including bowels movement. Results 132 patients were identified but 108 patients were included, who had surgery. 24 patients were excluded because they did not have post-gastrograffin x-ray. Average age of patients was 63+/-14 years. It was observed that 82 patients (75.9%) opened their bowels after administration of first dose of gastrograffin, while 26 patients (24%) did not. 16 out of these 26 patients required surgery; and the remaining 10 (38.4%) had 2nd dose of gastrograffin, of which 4 patients (40%) moved bowels but 6 (60%) still did not and required surgery. Post-contrast x-rays, showed that contrast passed through into large bowel in 76 patients (70.3%) after 1st dose of gastrograffin and in further 40% after 2nd dose. Conclusion clinically significant number of patients responded to such conservative measures. Therefore, routine oral gastrograffin usage is suggested as an effective adjunct to non-operative measures in adhesive SBO management.