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Use of gastrografin in the management of worm-induced small bowel obstruction in children
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Use of gastrografin in the management of worm-induced small bowel obstruction in children
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Journal Article
Use of gastrografin in the management of worm-induced small bowel obstruction in children
2015
Overview
Objective
Ascaris
-induced small bowel obstruction (SBO) is a common sequel of
Ascaris lumbricoides
(AL) infestation. Most cases respond to conservative treatment practiced in different centers worldwide. We conceived a prospective randomized trial to compare the conservative treatment with gastrografin administered in addition to the conservative treatment.
Study design
This prospective randomized study was conducted between January 2011 and June 2014 at Department of Paediatric and Neonatal Surgery, a tertiary-care hospital. Patients were divided into two groups, one group received conservative treatment and the other received gastrografin in addition to conservative treatment. Forty patients having uncomplicated AL-induced SBO were included in each group. Gastrografin was administered through nasogastric tube and serial clinical and radiological monitoring was performed. The duration of hospital stay, time between admission and first oral feed, passage of worms/flatus were compared in the two groups. Student’s
t
test was used for comparing these variables.
Results
Average time for passage of flatus or worms and resolution of abdominal signs and was shorter in gastrografin group as compared to the conservative group. This difference was found to be statistically significant. The average duration of hospital stay in gastrografin group was 25.20 ± 8.01 h whereas it was 61.12 ± 14.64 h in the conservative group (
P
< 0.001). The difference in the operation rate was statistically insignificant (2 in gastrografin group and 3 in the conservative group).No serious adverse reaction was noted after gastrografin administration.
Conclusion
Use of gastrografin resulted in faster relief of signs and symptoms of AL-induced SBO, early passage of worms/flatus and return to oral feeds. However, the role of gastrografin role in reducing the likelihood of laparotomy remains inconclusive. Adverse effects of gastrografin can be prevented if it is used in well-hydrated patients.
Publisher
Springer Berlin Heidelberg,Springer Nature B.V
Subject
/ Ascaris
/ Child
/ Contrast Media - therapeutic use
/ Diatrizoate Meglumine - therapeutic use
/ Female
/ Humans
/ India
/ Intestinal Obstruction - diagnostic imaging
/ Intestinal Obstruction - drug therapy
/ Intestinal Obstruction - parasitology
/ Intestine, Small - diagnostic imaging
/ Intestine, Small - parasitology
/ Length of Stay - statistics & numerical data
/ Male
/ Medicine
/ Surgery
