WOFAPS 2025 8th World Congress of Pediatric Surgery

Nabila Talat, Ehtisham Azmat, Sajid Nayyar, Wajeeh Rehman, Aziz Ahmed Chattha

University of child health sciences, The Childrens Hospital, Lahore

Background

Adhesive small bowel obstruction (ASBO) is a common and serious complication in children after abdominal surgery, often requiring complex surgical intervention. Recently, interest has grown in using Gastrografin to help manage ASBO without surgery. This study was conducted to investigate its potential role as a treatment option in children not responding to initial conservative care.

Methods

This quasi-experimental study was conducted between July 2023 and December 2024. Children with adhesive small bowel obstruction who didn’t improve with initial conservative care were given a trial of Gastrograffin in 1:1 dilution with normal saline via nasogastric tube in an amount of 5-7ml/Kg and monitored over 48 hours with serial abdominal radiographs. Outcomes included clinical resolution, time to improvement, and need for surgery.

Results

Out of 32 children with adhesive small bowel obstruction, 26 (81.2%) responded successfully to the Gastrografin trial. Most showed improvement within 24 hours, avoiding the need for surgery. The average hospital stay after Gastrografin trial was 3 days, and no major complications related to contrast were reported.

Conclusion

Gastrografin was effective in resolving adhesive small bowel obstruction in most children, reducing the need for surgery and hospital stay. The findings suggest it can ease both medical and financial burdens. Larger trials and standardized protocols are needed to confirm and guide its future use.