AIM: Gastrografin is a hyperosmolar water-soluble contrast medium. Besides its predictive value for the need for operative treatment, a potential therapeutic role of this agent in adhesive small bowel obstruction has ...AIM: Gastrografin is a hyperosmolar water-soluble contrast medium. Besides its predictive value for the need for operative treatment, a potential therapeutic role of this agent in adhesive small bowel obstruction has been suggested. This study aimed at evaluating the effectiveness of gastrografin in adhesive small bowel obstruction when conservative treatment failed. METHODS: Patients with adhesive small bowel obstruction were given trial conservative treatment unless there was fear of bowel strangulation. Those responded in the initial 48 h had conservative treatment continued. Patients who showed no improvement in the initial 48 h were given 100 mL of gastrografin through nasogastric tube followed by serial abdominal radiographs. Patients with the contrast appeared in large bowel within 24 h were regarded as having partial obstruction and conservative treatment was continued. Patients in which the contrast failed to reach large bowel within 24 h were considered to have complete obstruction and laparotomy was performed. RESULTS: Two hundred and twelve patients with 245 episodes of adhesive obstruction were included. Fifteen patients were operated on soon after admission due to fear of strangulation. One hundred and eighty-six episodes of obstruction showed improvement in the initial 48 h and conservative treatment was continued. Two patients had subsequent operations because of persistent obstruction. Forty-four episodes of obstruction showed no improvement within 48 h and gastrografin was administered. Seven patients underwent complete obstruction surgery. Partial obstruction was demonstrated in 37 other cases, obstruction resolved subsequently in all of them except one patient who required laparotomy because of persistent obstruction. The overall operative rate in this study was 10%. There was no complication that could be attributed to the use of gastrografin. CONCLUSION: The use of gastrografin in adhesive small bowel obstruction after unsuccessful conservative treatment is safe and reduces the need for suraical intervention展开更多
We report a case of a 59-year-old woman who was diagnosed with gastric and small intestinal anisakiasis, which was successfully treated with endoscopic extraction and Gastrografin therapy. She was admitted to our hosp...We report a case of a 59-year-old woman who was diagnosed with gastric and small intestinal anisakiasis, which was successfully treated with endoscopic extraction and Gastrografin therapy. She was admitted to our hospital with epigastric pain and vomiting one day after eating raw fish. She exhibited tenderness in the epigastrium without obvious rebound tenderness or guarding. Computed tomography (CT) demonstrated segmental edema of the intestinal wall with proximal dilatation and a small number of ascites. Because enteric anisakiasis was suspected based on the patient's history of recent raw fish consumption and abdominal CT, we performed gastroscopy and confirmed that nine Anisakis larvae were attached to the gastric mucosa. All of the Anisakis larvae were extracted via endoscopy, and the patient was diagnosed with gastric and enteric anisakiasis. Additionally, in the hospital, we performed ileography twice using Gastrografin, which led to shortened hospital stay. Based on the clinical results of this case, we suggest that Gastrografin therapy is a safe, convenient, and useful method to extract enteric Anisakis larvae.展开更多
AIM: Postoperative gastrointestinal-tract motility is normally delayed. Early feeding after colorectal surgery has been reported recently, but late feeding is common. Gastrografin not only enhances bowel peristalsis, ...AIM: Postoperative gastrointestinal-tract motility is normally delayed. Early feeding after colorectal surgery has been reported recently, but late feeding is common. Gastrografin not only enhances bowel peristalsis, but also decreases bowel-wall edema. Whether contrast medium allows early oral feeding and reduces the duration of hospitalization requires clarification. METHODS: Fifty patients underwent elective colorectal surgery In a regional medical center. Patients were prosp-ectively randomized into a Gastrografin group or control group (n=25 each). Patients in the Gastrografin group began their feeding schedule with 100 mL of 5% dextrose water with 100 mL of Gastrografin on postoperative d 3 and were advanced to a full liquid diet when the contrast reached the colon in 4 h. Patients in the control group began their feeding schedule with 200 mL of 5% dextrose water on postoperative d 3 and were advanced to a full liquid diet after the passage of flatus and stool. Nasogastric tubes were inserted for persistent postoperative vomiting. Fullness, nausea, vomiting, complications, time of anesthesia, time of operation, time of mobilization, time of oral feeding, and duration of hospital stay were recorded and analyzed with Student's t-test. RESULTS: In the Gastrografin group, one patient had aspiration pneumonia and one patient had anastomotic leakage resulting in sepsis and eventual death. This mortality was excluded from the subsequent statistical analysis. In the control group, two patients had wound infections. There was no significant difference between the two groups at the time of anesthesia, time of operation, or time of mobilization. There were significant differences between the two groups in the time of oral feeding (3.3±0.3 d in the Gastrografin group VS 4.8±0.4 d in the control group; P=odds ratio--, 95%CI [-0.5 to +0.7 d]) and in the length of hospital stay (7.6±1.1 d in the Gastrografin group VS 10.2±1.3 d in the control group; P=odds ratio--, 95% CI [-1.2 to +1.4 d]). CONCLUSION: Gastrografin not only allowed early oral feeding but also reduced the duration of hospitalization after elective colorectal surgery.展开更多
BACKGROUND Gastrografin swallow,methylthioninium chloride test,and computed tomography(CT)are the main methods for postoperative anastomotic fistula detection.Correct selection and application of examinations and ther...BACKGROUND Gastrografin swallow,methylthioninium chloride test,and computed tomography(CT)are the main methods for postoperative anastomotic fistula detection.Correct selection and application of examinations and therapies are significant for the early diagnosis and treatment of small anastomotic fistulas after radical gastrectomy,which are conducive to postoperative recovery.CASE SUMMARY A 44-year-old woman underwent radical total gastrectomy for laparoscopic gastric cancer.The patient developed a fever after surgery.The methylthioninium chloride test and early CT suggested no anastomotic fistula,but gastrografin swallow and late CT showed the opposite result.The fistula was successfully closed using an endoscopic clip.The methylthioninium chloride test,gastrografin,and CT performed on different postoperative dates for small esophagojejunostomy fistulas are different.The size of the anastomotic fistula is an important factor for the success of endoscopic treatment.CONCLUSION The advantages and limitations of the diagnosis of different examinations of small esophagojejunostomy fistulas are noteworthy.The size of the leakage of the anastomosis is an important basis for selecting the repair method.展开更多
目的探讨水溶性造影剂（泛影葡胺）在粘连性小肠梗阻治疗中的价值。方法明确诊断为小肠梗阻的患者,不合并肠穿孔、腹膜炎及绞窄性肠梗阻等需要急诊手术的情况。采用前瞻性研究方法,将入组的57例患者分为2组：对照组与治疗组。对照组给...目的探讨水溶性造影剂（泛影葡胺）在粘连性小肠梗阻治疗中的价值。方法明确诊断为小肠梗阻的患者,不合并肠穿孔、腹膜炎及绞窄性肠梗阻等需要急诊手术的情况。采用前瞻性研究方法,将入组的57例患者分为2组：对照组与治疗组。对照组给予常规治疗,如禁食、胃肠减压、灌肠、静脉补液等;治疗组除常规保守治疗方法外,患者口服或均经胃肠减压管注入76%泛影葡胺60~100 m L并夹管1小时,观察两组非手术治疗的有效率、小肠梗阻缓解时间、住院时间以及并发症的发生情况。结果应用泛影葡胺的治疗组非手术治疗的有效率明显高于对照组（83.3%VS 55.6%）,差异有统计学意义;非手术治疗有效的两组患者中,治疗组患者在肠鸣音恢复时间9.56±3.47 h VS 19.67±3.90 h）、肛门排气时间（11.24±3.15 h VS 22.6±4.14 h）、每日胃肠减压量（179.20±68.79 m L VS 323.33±91.31 m L）、住院时间（5.0±1.83 d VS 8.20±2.15 d）均明显小于对照组,各指标间的比较均有显著性差异。两组均未出现严重并发症。结论泛影葡胺治疗小肠梗阻疗效确切,值得推广应用。展开更多
文摘AIM: Gastrografin is a hyperosmolar water-soluble contrast medium. Besides its predictive value for the need for operative treatment, a potential therapeutic role of this agent in adhesive small bowel obstruction has been suggested. This study aimed at evaluating the effectiveness of gastrografin in adhesive small bowel obstruction when conservative treatment failed. METHODS: Patients with adhesive small bowel obstruction were given trial conservative treatment unless there was fear of bowel strangulation. Those responded in the initial 48 h had conservative treatment continued. Patients who showed no improvement in the initial 48 h were given 100 mL of gastrografin through nasogastric tube followed by serial abdominal radiographs. Patients with the contrast appeared in large bowel within 24 h were regarded as having partial obstruction and conservative treatment was continued. Patients in which the contrast failed to reach large bowel within 24 h were considered to have complete obstruction and laparotomy was performed. RESULTS: Two hundred and twelve patients with 245 episodes of adhesive obstruction were included. Fifteen patients were operated on soon after admission due to fear of strangulation. One hundred and eighty-six episodes of obstruction showed improvement in the initial 48 h and conservative treatment was continued. Two patients had subsequent operations because of persistent obstruction. Forty-four episodes of obstruction showed no improvement within 48 h and gastrografin was administered. Seven patients underwent complete obstruction surgery. Partial obstruction was demonstrated in 37 other cases, obstruction resolved subsequently in all of them except one patient who required laparotomy because of persistent obstruction. The overall operative rate in this study was 10%. There was no complication that could be attributed to the use of gastrografin. CONCLUSION: The use of gastrografin in adhesive small bowel obstruction after unsuccessful conservative treatment is safe and reduces the need for suraical intervention
文摘We report a case of a 59-year-old woman who was diagnosed with gastric and small intestinal anisakiasis, which was successfully treated with endoscopic extraction and Gastrografin therapy. She was admitted to our hospital with epigastric pain and vomiting one day after eating raw fish. She exhibited tenderness in the epigastrium without obvious rebound tenderness or guarding. Computed tomography (CT) demonstrated segmental edema of the intestinal wall with proximal dilatation and a small number of ascites. Because enteric anisakiasis was suspected based on the patient's history of recent raw fish consumption and abdominal CT, we performed gastroscopy and confirmed that nine Anisakis larvae were attached to the gastric mucosa. All of the Anisakis larvae were extracted via endoscopy, and the patient was diagnosed with gastric and enteric anisakiasis. Additionally, in the hospital, we performed ileography twice using Gastrografin, which led to shortened hospital stay. Based on the clinical results of this case, we suggest that Gastrografin therapy is a safe, convenient, and useful method to extract enteric Anisakis larvae.
文摘AIM: Postoperative gastrointestinal-tract motility is normally delayed. Early feeding after colorectal surgery has been reported recently, but late feeding is common. Gastrografin not only enhances bowel peristalsis, but also decreases bowel-wall edema. Whether contrast medium allows early oral feeding and reduces the duration of hospitalization requires clarification. METHODS: Fifty patients underwent elective colorectal surgery In a regional medical center. Patients were prosp-ectively randomized into a Gastrografin group or control group (n=25 each). Patients in the Gastrografin group began their feeding schedule with 100 mL of 5% dextrose water with 100 mL of Gastrografin on postoperative d 3 and were advanced to a full liquid diet when the contrast reached the colon in 4 h. Patients in the control group began their feeding schedule with 200 mL of 5% dextrose water on postoperative d 3 and were advanced to a full liquid diet after the passage of flatus and stool. Nasogastric tubes were inserted for persistent postoperative vomiting. Fullness, nausea, vomiting, complications, time of anesthesia, time of operation, time of mobilization, time of oral feeding, and duration of hospital stay were recorded and analyzed with Student's t-test. RESULTS: In the Gastrografin group, one patient had aspiration pneumonia and one patient had anastomotic leakage resulting in sepsis and eventual death. This mortality was excluded from the subsequent statistical analysis. In the control group, two patients had wound infections. There was no significant difference between the two groups at the time of anesthesia, time of operation, or time of mobilization. There were significant differences between the two groups in the time of oral feeding (3.3±0.3 d in the Gastrografin group VS 4.8±0.4 d in the control group; P=odds ratio--, 95%CI [-0.5 to +0.7 d]) and in the length of hospital stay (7.6±1.1 d in the Gastrografin group VS 10.2±1.3 d in the control group; P=odds ratio--, 95% CI [-1.2 to +1.4 d]). CONCLUSION: Gastrografin not only allowed early oral feeding but also reduced the duration of hospitalization after elective colorectal surgery.
文摘BACKGROUND Gastrografin swallow,methylthioninium chloride test,and computed tomography(CT)are the main methods for postoperative anastomotic fistula detection.Correct selection and application of examinations and therapies are significant for the early diagnosis and treatment of small anastomotic fistulas after radical gastrectomy,which are conducive to postoperative recovery.CASE SUMMARY A 44-year-old woman underwent radical total gastrectomy for laparoscopic gastric cancer.The patient developed a fever after surgery.The methylthioninium chloride test and early CT suggested no anastomotic fistula,but gastrografin swallow and late CT showed the opposite result.The fistula was successfully closed using an endoscopic clip.The methylthioninium chloride test,gastrografin,and CT performed on different postoperative dates for small esophagojejunostomy fistulas are different.The size of the anastomotic fistula is an important factor for the success of endoscopic treatment.CONCLUSION The advantages and limitations of the diagnosis of different examinations of small esophagojejunostomy fistulas are noteworthy.The size of the leakage of the anastomosis is an important basis for selecting the repair method.
文摘目的探讨水溶性造影剂（泛影葡胺）在粘连性小肠梗阻治疗中的价值。方法明确诊断为小肠梗阻的患者,不合并肠穿孔、腹膜炎及绞窄性肠梗阻等需要急诊手术的情况。采用前瞻性研究方法,将入组的57例患者分为2组：对照组与治疗组。对照组给予常规治疗,如禁食、胃肠减压、灌肠、静脉补液等;治疗组除常规保守治疗方法外,患者口服或均经胃肠减压管注入76%泛影葡胺60~100 m L并夹管1小时,观察两组非手术治疗的有效率、小肠梗阻缓解时间、住院时间以及并发症的发生情况。结果应用泛影葡胺的治疗组非手术治疗的有效率明显高于对照组（83.3%VS 55.6%）,差异有统计学意义;非手术治疗有效的两组患者中,治疗组患者在肠鸣音恢复时间9.56±3.47 h VS 19.67±3.90 h）、肛门排气时间（11.24±3.15 h VS 22.6±4.14 h）、每日胃肠减压量（179.20±68.79 m L VS 323.33±91.31 m L）、住院时间（5.0±1.83 d VS 8.20±2.15 d）均明显小于对照组,各指标间的比较均有显著性差异。两组均未出现严重并发症。结论泛影葡胺治疗小肠梗阻疗效确切,值得推广应用。
