醫學五：80題 ( 包括外科,骨科,泌尿科等科目及其相關臨床實例與醫學倫理 )題庫下載題庫

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Uptodate:Gastrografin for adhesive small bowel obstruction

Diatrizoate meglumine-diatrizoate sodium (Gastrografin [GGF]) is the most commonly used water-soluble contrast medium for the treatment of adhesive small bowel obstruction (ASBO). Each 100 mL of GGF solution contains 10 grams of sodium diatrizoate and 66 grams of meglumine diatrizoate with an osmolarity of 2150 mOsm/L (approximately six times the osmolarity of extracellular fluid) [3,4].

Its main mechanism of action is by activating the movement of water into the small bowel lumen by osmosis and decreasing edema of the sm...

C是錯的QQ

Uptodate:Gastrografin for adhesive small bowel obstruction

Diatrizoate meglumine-diatrizoate sodium (Gastrografin [GGF]) is the most commonly used water-soluble contrast medium for the treatment of adhesive small bowel obstruction (ASBO). Each 100 mL of GGF solution contains 10 grams of sodium diatrizoate and 66 grams of meglumine diatrizoate with an osmolarity of 2150 mOsm/L (approximately six times the osmolarity of extracellular fluid) [3,4].

Its main mechanism of action is by activating the movement of water into the small bowel lumen by osmosis and decreasing edema of the small bowel wall. It probably also enhances smooth muscle contractile activity. The combination of these effects is thought to generate effective peristalsis, enabling the small bowel to overcome ASBO

A 2007 Cochrane review and meta-analysis concluded that the appearance of water-soluble contrast in the colon on an abdominal radiograph within 24 hours of its oral administration predicts clinical resolution of ASBO without surgery, with a pooled sensitivity of 97 percent and specificity of 96 percent.

It is important to point out that GGF appears to only accelerate the resolution of ASBO in patients who would have resolved eventually without surgery, rather than increase the success rate of nonoperative management.