Value of CT-Scan and Oral Gastrografin in the Management of Post Operative Small Bowel Obstruction
Status:
Completed
Trial end date:
2010-08-01
Target enrollment:
Participant gender:
Summary
Small bowel obstructions are responsible for 2 to 5% of emergency hospital admissions and 20%
of all emergency surgical procedures. In 60 to 80% of cases, acute small bowel obstructions
are the consequence of intraperitoneal postoperative adhesions. They constitute an extremely
frequent pathology, leading to a high rate of hospital admissions and money expense.
Management of small bowel obstruction is based on 2 options: either a surgical approach where
all patients are operating on, or a conservative treatment in which surgery is proposed in
case of failure of medical treatment. The surgical approach leads to operate on an excessive
rate of patients while the medical approach increases the risk of increased small bowel
resection, morbidity rate or hospitalization duration.
In order to improve the management of small bowel obstruction, it seems necessary to better
distinguish patients that need an emergency surgical procedure from patients in which medical
treatment will be useful. Many studies have been performed to investigate the value of
imaging in the management of small bowel obstruction, using abdominal X-ray, oral
gastrografin administration or CT-Scan.
The aim of this study is to analyse the effect of a systematic performance of imaging
investigation on the management of patients presenting with a postoperative small bowel
obstruction.
All patients suffering from a postoperative small bowel obstruction will be included in this
study. They will be randomised in 2 groups. In group S, patients will have CT-Scan and oral
water administration while in group SG, Patients will have CT-Scan and oral gastrografin
administration The major end point of this study is to analyse whether imaging examination
can reduce the need for a surgical approach or the rate of small bowel resection and to
determine its influence on fasting time or hospitalization duration