TTP8.01 Study of Different Water-Soluble Contrast Agents for Small Bowel Obstruction

Aim Small bowel obstruction (SBO) is a common surgical emergency accounting for 12% to 16% of all emergency surgical admissions in the UK. Patients with SBO typically undergo a trial of conservative management with water soluble contrast (WSC) study. The main agent used is meglumine amidotrizoate with sodium amidotrizoate (Gastrografin). Gastrografin is a hypertonic radio-opaque agent with an osmolality greater than 6 times that of extra-cellular fluid. It works by drawing water via osmosis into the gastro-intestinal lumen from the abdominal space, thereby reducing oedema, and encouraging peristalsis as a result, to relieve obstruction. However, due to international supply shortages of Gastrografin, we trialled other WSC agents including Iopamidol 61.24% (Gastromiro) and concentrated Iohexol (Omnipaque 300). In this study, we aimed to see if either or WSC agent had any therapeutic benefit in the management of conservative SBO. Methods A single centre, retrospective study carried out between 01/03/2024 and 01/07/2024. Inclusion criteria: Patients with SBO who had conservative management with WSC study. Exclusion criteria(s): Patients who immediately had surgery without WSC. Patients without SBO confirmed on radiological investigation. Results A total of 38 WSC Studies were carried out, 34 met the criteria comprised of: Gastrografin (n=21) 14/21 successful (67%), Omnipaque 300 (n=11) 10/11 successful (91%) and Gastromiro (n=2) 2/2 successful (100%). Conclusion Omnipaque 300 and Gastromiro are possibly useful alternatives to Gastrografin for therapeutic conservative management of SBO. In the absence of Gastrografin, either agent should be considered. A repeat study should be conducted,