In adhesive small bowel obstruction (SBO), the Gastrografin challenge involves oral or nasogastric administration of water-soluble contrast. Appearance of contrast in the colon within 24 hours predicts:
- A Partial obstruction requiring urgent surgery
- B Successful resolution with non-operative management ✓
- C Strangulation of bowel requiring immediate laparotomy
- D Complete obstruction with need for CT confirmation
Correct answer: B. Successful resolution with non-operative management
Explanation
The Gastrografin challenge has both diagnostic and therapeutic value in adhesive SBO. Failure of contrast to reach the colon within 24 hours predicts failure of non-operative management, mandating surgical intervention. Contrast reaching the colon within 24 hours predicts spontaneous resolution and can shorten hospital stay. Gastrografin also has a therapeutic osmotic effect that draws fluid into the bowel lumen, potentially relieving the obstruction.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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