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  • Title: Water-soluble contrast agent in adhesive small bowel obstruction: a systematic review and meta-analysis of diagnostic and therapeutic value.
    Author: Ceresoli M, Coccolini F, Catena F, Montori G, Di Saverio S, Sartelli M, Ansaloni L.
    Journal: Am J Surg; 2016 Jun; 211(6):1114-25. PubMed ID: 26329902.
    Abstract:
    BACKGROUND: Adhesive small bowel obstructions are the most common postoperative causes of hospitalization. Several studies investigated the diagnostic and therapeutic role of water-soluble contrast agent (WSCA) in predicting the need for surgery, but there is no consensus. METHODS: A systematic review and meta-analysis was done of studies on diagnostic and therapeutic role of oral WSCA. RESULTS: WSCA had a sensitivity of 92% and a specificity of 93% in predicting resolution of obstruction without surgery; diagnostic accuracy increased significantly if abdominal X-rays were taken after 8 hours. The administration of oral WSCA reduced the need for surgery (odds ratio .55, P = .003), length of stay (weighted mean difference -2.18 days, P < .00001), and time to resolution (weighted mean difference -28.25 hours, P < .00001). No differences in terms of morbidity or mortality were recorded. CONCLUSIONS: The administration of WSCA is accurate in predicting the need for surgery; the test should be taken after at least 8 hours from administration. WSCA is a proven safe and effective treatment, correlated with a significant reduction in the need for surgery and in the length of hospital stay.
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