Y. M. Baghdadi1, M. Amr1, M. A. Khasawneh1, S. Polites1, M. Zielinski1 1Mayo Clinic,Rochester, MN, USA
Introduction: The Gastrografin® Challenge is a diagnostic and therapeutic tool to treat patients with small bowel obstruction (SBO), however, long-term data on SBO recurrence after the Gastrografin® Challenge is limited. We hypothesized that patients treated with Gastrografin® would have the same long-term recurrence as those treated prior to the implementation of the Gastrografin® Challenge protocol.
Methods: Institutional review board approval was obtained to review medical records of patients 18 years or older admitted for acute SBO between 7/2009-9/2011. Patients with contraindications to the Gastrografin® Challenge (i.e. signs of strangulation) were excluded. Kaplan-Meier method was used to describe the time-dependent outcomes. Data is presented as mean ± standard deviation, or percentage, as appropriate.
Results: A total of 191 patients were identified of whom 52 received the Gastrografin® Challenge (27%). The mean age was 65 ± 17 years with 103 women (54%). Operative exploration and complications during the initial hospitalization were less common in patients who underwent the Gastrografin® Challenge (27% vs 42%, p=0.045, and 10% vs 39%, p<0.0001, respectively). The duration of index hospitalization was comparable (9 vs 9 days, p= 0.87). Overall survival from recurrence was 91% (95%CI: 76.5%-96.7%) over 12 months (Figure 1). There were no recurrences among patients who received the Gastrografin® Challenge at one year follow-up (survival rates; 0% vs 86.9%, p=0.04).
Conclusion: The Gastrografin ® challenge is safe and promising tool in managing patients with SBO with fewer explorations at the index of admission and subsequent lower recurrence rates during follow-up.
