Value of CT-Scan and Oral Gastrografin in the Management of Post Operative Small Bowel Obstruction
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
|Study Design:||Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Single Blind (Subject)
Primary Purpose: Treatment
|Official Title:||Value of CT-Scan and Oral Gastrografin in the Management of Post Operative Small Bowel Obstruction|
- Need for surgical management [ Time Frame: 2 months ] [ Designated as safety issue: Yes ]
- Sensibility and specificity of gastrografin oral administration [ Time Frame: 2 months ] [ Designated as safety issue: Yes ]
- Sensibility and specificity of CT-Scan. [ Time Frame: 2 months ] [ Designated as safety issue: Yes ]
- Sensibility and specificity of abdominal X-ray. [ Time Frame: 2 months ] [ Designated as safety issue: Yes ]
- Fasting time [ Time Frame: 2 months ] [ Designated as safety issue: Yes ]
- Hospitalization time [ Time Frame: 2 months ] [ Designated as safety issue: Yes ]
- Number of small bowel resection [ Time Frame: 2 months ] [ Designated as safety issue: Yes ]
|Study Start Date:||November 2006|
|Study Completion Date:||August 2010|
|Primary Completion Date:||August 2009 (Final data collection date for primary outcome measure)|
|Placebo Comparator: 2||
oral water ingestion
|Rouen, France, 76000|
|Principal Investigator:||michel scotté, MD,PhD||CHU Rouen|
|Study Director:||francois mauvais, MD||chg Beauvais|
|Study Director:||jean-marc regimbeau, MD, PhD||CHU amiens|