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Article: An audit of the upper gastrointestinal contrast examination protocol in patients with suspected small bowel obstruction

TitleAn audit of the upper gastrointestinal contrast examination protocol in patients with suspected small bowel obstruction
Authors
KeywordsClinical audit
Diatrizoate meglumine
Fluoroscopy
Intestinal obstruction
Issue Date2009
PublisherScientific Communications International Ltd. The Journal's web site is located at http://www.hkcr.org/
Citation
Journal Of The Hong Kong College Of Radiologists, 2009, v. 12 n. 2, p. 57-59 How to Cite?
AbstractObjective: Small bowel follow-through examination with Gastrografin (diatrizoate meglumine and diatrizoate sodium solution) is important for delineating the cause of small bowel obstruction. However, whether the standard protocol should include the 24-hour delayed image is uncertain. This retrospective study was performed to review the usefulness of the 24-hour delayed image and the subsequent treatment of patients suspected to have small bowel obstruction. Methods: All urgent Gastrografin follow-through examinations conducted from 1 January 2007 to 31 December 2007 were evaluated. Clinical data, including demographic data, presenting symptoms, imaging findings, subsequent treatment, and clinical outcomes were reviewed from the Electronic Patient Record, Radiology Information System, and medical records. Results: Seventy five examinations were performed, and 4 patients were excluded because of intolerance and subsequent incomplete examination. The commonest indication was acute small bowel obstruction (n = 66; 93%). Of 21 patients (30%) with positive results, 6 had significant small bowel obstruction diagnosed by imaging within 8 hours with no 24-hour delayed image, and 5 of these patients underwent emergency operation; the sixth patient rapidly worsened preoperatively. Of 15 patients with positive results confirmed by 24-hour delayed images, 14 required emergency operation, with complete bowel obstruction confirmed intraoperatively. For the 50 patients with negative results, 9 (18%) required 24-hour delayed images to confirm the radiological diagnosis, 3 (33%) of whom underwent emergency operation due to their deteriorating clinical condition; complete bowel obstruction was confirmed intraoperatively for all 3 patients. Conclusions: This audit of the role of 24-hour delayed imaging had a high false-negative rate (30%). Therefore, the standard protocol may be amended to eliminate the 24-hour delayed image to avoid delay to effective management of small bowel obstruction. © 2009 Hong Kong College of Radiologists.
Persistent Identifierhttp://hdl.handle.net/10722/124629
ISSN
References

 

DC FieldValueLanguage
dc.contributor.authorChu, TYCen_HK
dc.contributor.authorWong, CSen_HK
dc.contributor.authorMak, WSen_HK
dc.contributor.authorMa, KFen_HK
dc.contributor.authorCheng, LFen_HK
dc.date.accessioned2010-10-31T10:45:13Z-
dc.date.available2010-10-31T10:45:13Z-
dc.date.issued2009en_HK
dc.identifier.citationJournal Of The Hong Kong College Of Radiologists, 2009, v. 12 n. 2, p. 57-59en_HK
dc.identifier.issn1029-5097en_HK
dc.identifier.urihttp://hdl.handle.net/10722/124629-
dc.description.abstractObjective: Small bowel follow-through examination with Gastrografin (diatrizoate meglumine and diatrizoate sodium solution) is important for delineating the cause of small bowel obstruction. However, whether the standard protocol should include the 24-hour delayed image is uncertain. This retrospective study was performed to review the usefulness of the 24-hour delayed image and the subsequent treatment of patients suspected to have small bowel obstruction. Methods: All urgent Gastrografin follow-through examinations conducted from 1 January 2007 to 31 December 2007 were evaluated. Clinical data, including demographic data, presenting symptoms, imaging findings, subsequent treatment, and clinical outcomes were reviewed from the Electronic Patient Record, Radiology Information System, and medical records. Results: Seventy five examinations were performed, and 4 patients were excluded because of intolerance and subsequent incomplete examination. The commonest indication was acute small bowel obstruction (n = 66; 93%). Of 21 patients (30%) with positive results, 6 had significant small bowel obstruction diagnosed by imaging within 8 hours with no 24-hour delayed image, and 5 of these patients underwent emergency operation; the sixth patient rapidly worsened preoperatively. Of 15 patients with positive results confirmed by 24-hour delayed images, 14 required emergency operation, with complete bowel obstruction confirmed intraoperatively. For the 50 patients with negative results, 9 (18%) required 24-hour delayed images to confirm the radiological diagnosis, 3 (33%) of whom underwent emergency operation due to their deteriorating clinical condition; complete bowel obstruction was confirmed intraoperatively for all 3 patients. Conclusions: This audit of the role of 24-hour delayed imaging had a high false-negative rate (30%). Therefore, the standard protocol may be amended to eliminate the 24-hour delayed image to avoid delay to effective management of small bowel obstruction. © 2009 Hong Kong College of Radiologists.en_HK
dc.languageengen_HK
dc.publisherScientific Communications International Ltd. The Journal's web site is located at http://www.hkcr.org/en_HK
dc.relation.ispartofJournal of the Hong Kong College of Radiologistsen_HK
dc.subjectClinical auditen_HK
dc.subjectDiatrizoate meglumineen_HK
dc.subjectFluoroscopyen_HK
dc.subjectIntestinal obstructionen_HK
dc.titleAn audit of the upper gastrointestinal contrast examination protocol in patients with suspected small bowel obstructionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1029-5097&volume=12&issue=2&spage=57&epage=59&date=2009&atitle=An+audit+of+the+upper+gastrointestinal+contrast+examination+protocol+in+patients+with+suspected+small+bowel+obstruction-
dc.identifier.emailWong, CS:drcswong@hku.hken_HK
dc.identifier.authorityWong, CS=rp01391en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.scopuseid_2-s2.0-76349103697en_HK
dc.identifier.hkuros174678en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-76349103697&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume12en_HK
dc.identifier.issue2en_HK
dc.identifier.spage57en_HK
dc.identifier.epage59en_HK
dc.publisher.placeHong Kongen_HK
dc.identifier.scopusauthoridChu, TYC=25521167800en_HK
dc.identifier.scopusauthoridWong, CS=24605454100en_HK
dc.identifier.scopusauthoridMak, WS=35995543300en_HK
dc.identifier.scopusauthoridMa, KF=23025417700en_HK
dc.identifier.scopusauthoridCheng, LF=9246781300en_HK

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