446 Efficacy of Early Gastrografin Use in Adhesional Small Bowel Obstruction

Abstract Aim The aim of this audit was to establish the outcomes in patients who receive gastrografin versus patients who do not receive gastrografin in patients with adhesional small bowel obstruction (SBO). Method This was a retrospective data collection of patients admitted with “small bowel obstruction” between June and September 2021. Further patient selection criteria were applied. Data was collected using the EPR system and assimilated using Excel spreadsheet. Results A total of 76 patients with SBO were identified. 32 patients were diagnosed with adhesional SBO. Of these, 21/32 had previous maximally invasive surgery, 7/32 has previous minimally invasive surgery, and 4/32 had no previous surgery. 17/32 patients received gastrografin, of which 15 resolved and 2 needed surgery (1×laparoscopic adhesiolysis and 1×laparotomy). Average length of stay in patients who received gastrografin was 4.2 days. 15/32 patients did not receive gastrografin, of which 6 resolved and 9 needed surgery (7×laprascopic adhesiolysis and 2×laparotomy). Average length of stay in patients who did not receive gastrografin was 10.3 days. Conclusions Early use of gastrografin in stable patients with adhesional SBO appears to have good outcomes and should be considered after discussion with senior clinicans. Patients who are septic, severely tender on examination or who show signs of ischaemia should not have surgery delayed. Formal standard operating procedures (SOP) should be developed for the management of adhesional SBO.