Therapeutic Role of Water-Soluble Contrast Media in Resolution of Subacute Intestinal Obstruction

Background: Subacute intestinal obstruction (SAIO) is a common surgical emergency that often responds to conservative management, but delayed resolution may necessitate surgery. The introduction of water-soluble contrast media (WSCM), such as Gastrografin, has provided both diagnostic and therapeutic benefits by promoting intestinal motility and reducing wall edema. This study evaluates the therapeutic efficacy of WSCM in resolving SAIO and reducing the need for operative intervention.

Methods: A prospective comparative study was conducted at a tertiary care hospital between January 2023 and December 2024, including 120 adult patients with radiologically confirmed SAIO. Patients were divided into two groups: Group A received standard conservative management, while Group B received 100 mL of diluted Gastrografin via nasogastric tube in addition to standard care. Clinical and radiological outcomes were assessed over 48 hours. Statistical analysis was performed using SPSS v26, with p<0.05 considered significant.

Results: Resolution of obstruction occurred in 78% of patients in Group B compared with 46% in Group A (p<0.05). The mean hospital stay was significantly shorter in Group B (3.2 ± 1.4 days) compared to Group A (5.8 ± 1.9 days). Surgical intervention was required in 14% of the contrast group versus 32% in the control group. No major adverse events were recorded.

Conclusion: Water-soluble contrast media significantly enhance the resolution rate of subacute intestinal obstruction, shorten hospitalization, and reduce surgical requirements. Gastrografin is a safe and effective adjunct to conservative therapy in stable SAIO patients.