Retrospective Comparison of
Urografin Versus Standard Therapy in Postoperative
Intestinal Obstructions After Gynecologic and Obstetric Surgery
Murat DEDE, Gökhan YAĞCI, Nihat KAYMAKÇIOĞLU, Ümit GÖKTOLGA,
Müfit Cemal YENEN, İskender BAŞER, Sadettin ÇETİNER
Ankara-Turkey
OBJECTIVE: The objective of this study was to evaluate the therapeutic effect of water soluble contrast substances such as Urografin in postoperative intestinal obstructions following major gynecological and obstetrical surgical interventions.
STUDY DESIGN: In this retrospective study, data from patients at the Departments of General Surgery or Gynecology-Obstetrics, who admitted with the diagnosis of or developed ileus were analyzed. Patient demographics, surgical procedures, treatment modalities, information about ileus, and results of Urografin study were recorded. Following the diagnosis of ileus, standing plain abdominal X-ray (SPAR) was taken and 40 ml Urografin+40 ml water were administered to the patients. Serial plain abdominal X-rays at standing position were taken at the 1st, 2nd, 4th and 6th hours after administration. If Urografin failed to pass to colon after 6 hours, ileus was treated.
RESULTS: In 40 cases (74.07%), Urografin passage to colon was observed in 6 hours following the administration. Colon passage was most frequent between the first 2-4 hours (52.2%). These patients were treated medically (IV fluid replacement, naso-gastric decompression, antibiotics). In 14 patients (25.9%), no passage was present. Three of them recovered with medical treatment, while others underwent surgical intervention. Sensitivity was 93.02%, specificity was 100%, positive predictive value was 100% and negative predictive value was 78.5% for therapeutic efficacy of Urografin passage to colon 6 hours after administration.
CONCLUSION: It was concluded that water soluble contrast substances are effective, safe and easy to use in diagnosis and treatment of postoperative ileus.
(Gynecol Obstet Reprod Med 2005; 11:194-198)
Key Words: Urografin, Intestinal obstructions, Ileus
