Evaluating the Role of Oral Water Soluble Contrast in Adhesive Intestinal Obstruction among Children

Mohamed, Mohamed Shaban Abdelnaby; Abdel-Latif, Mohammed; El-Asmar, Khaled Mohamed; Ahmed, Gehad

doi:10.21608/asmj.2025.363235.1401

Evaluating the Role of Oral Water Soluble Contrast in Adhesive Intestinal Obstruction among Children

Document Type : Original Article

Authors

¹ Pediatric Surgery Department, Faculty of medicine,Helwan University, Cairo, Egypt

² Pediatric Surgery Department, Faculty of medicine, Helwan University, Cairo, Egypt

³ Pediatric Surgery Department, Faculty of medicine, Ain Shams University, Cairo, Egypt

⁴ General Surgery Department, Faculty of medicine, Helwan University, Cairo, Egypt

10.21608/asmj.2025.363235.1401

Abstract

Background: Adhesive small intestinal obstruction (ASBO) is a common pediatric surgical emergency and a major cause of
postoperative morbidity, requiring prompt diagnosis and management.
Aim: To evaluate the role of non-ionic oral water-soluble contrast (Iohexol) in ASBO among children.
Methods: A prospective comparative study on children with ASBO (November 2022–January 2024). After excluding
peritonitis and perforation, all underwent 24-hour conservative management. Non-responders were simply randomized into two groups: non-contrast (group I) and contrast (group II) using Iohexol. Both groups were monitored by serial examinations and radiography.
Results: Thirty cases were enrolled, with 15 in each group. Group I had 9 males and 6 females (ages 1–13 9/12 years), and
Group II had 10 males and 5 females (ages 1–12 11/12 years). In Group I, 5 cases (33.3%) required surgery. Median time till initial oral intake and hospital stay were 36 hours (31.5–39.5) and 115.5 hours (106–121.5), respectively. In Group II, contrast reached the cecum in 12 cases (80%). Median time till initial oral intake and hospital stay were 9 hours (6–12) and 60 hours (54–66), respectively. While success rates showed no significant difference (P = 0.6817), Group II had significantly shorter time till initial oral intake and hospital stay (P < 0.001). Recurrence rates were 30% (Group I) and 16.7% (Group II), with no significant difference (P = 0.6241).
Conclusion: Non-ionic water-soluble contrast helps avoid unnecessary surgeries and shortens hospital stays in ASBO, likely due to its diagnostic role.

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