alexa Efficacy of Gastrografin ® Compared with Stan
ISSN: 2167-0870

Journal of Clinical Trials
Open Access

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Research Article

Efficacy of Gastrografin ® Compared with Standard Conservative Treatment in Management of Adhesive Small Bowel Obstruction at Mulago National Referral Hospital

Caspar Haule, Peter A Ongom* and Timothy Kimuli
Department of Surgery, School of Medicine, Makerere University College of Health Sciences, Makerere University, P O Box 7072, Kampala, Uganda
Corresponding Author : Peter A. Ongom
Department of Surgery, School of Medicine, Makerere University College of Health Sciences
Makerere University, P O Box 7072, Kampala, Uganda
Tel: 256 772 454 936, 256 701 629 160
E-mail:[email protected]
Received August 13, 2013; Accepted September 23, 2013; Published September 25, 2013
Citation: Haule C, Ongom PA, Kimuli T (2013) Efficacy of Gastrografin® Compared with Standard Conservative Treatment in Management of Adhesive Small Bowel Obstruction at Mulago National Referral Hospital. J Clin Trials 3:144. doi:10.4172/2167-0870.1000144
Copyright: © 2013 Ongom PA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

Introduction: The treatment of adhesive small bowel obstruction is controversial, with both operative and nonoperative management practiced in different centers worldwide. Non-operative management is increasingly getting popular, though operative rates still remain high. A study to compare the efficacy of an oral water-soluble medium (Gastrografin®) with standard conservative management, both non-operative methods, in the management of this condition was conducted in a tertiary Sub Saharan hospital. Methods: An open randomised controlled clinical trial was conducted between September 2012 and March 2013 at Mulago National Referral and Teaching Hospital, Uganda. Fifty patients of both genders, with adhesive small bowel obstruction, in the hospital’s emergency and general surgical wards were included. Randomisation was to Gastrografin® and standard conservative treatment groups. The primary outcomes were: the time interval between admission and relief of obstruction, the length of hospital stay, and the rates of operative surgery. Results: All 50 recruited patients were followed up and analysed; 25 for each group. In the Gastrografin® group, 22 (88%) patients had relief of obstruction following the intervention, with 3 (12%) requiring surgery. The conservative treatment group had 16 (64%) patients relieved of obstruction conservatively, and 9 (36%) required surgery. The difference in operative rates between the two groups was not statistically significance (P = 0.67). Average time to relief of obstruction was shorter in the Gastrografin® group (72.52 hrs) compared to the conservative treatment group (117.75 hrs), a significant difference (P = 0.023). The average length of hospital stay was shorter in the Gastrografin® group (5.62 days) compared to the conservative treatment group (10.88 days), a significant difference (P = 0.04). Conclusion: The use of Gastrografin® in patients with adhesive small bowel obstruction helps in earlier resolution of obstruction and reduces the length of hospital stay compared with standard conservative management. Its role in reducing the rate of laparotomies remains inconclusive.

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