{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:36:11Z","timestamp":1791264971433,"version":"4.1.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2007,3,23]],"date-time":"2007-03-23T00:00:00Z","timestamp":1174608000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,3,23]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Adhesions are the leading cause of small bowel obstruction. Identification of patients who require surgery is difficult. This review analyses the role of Gastrografin\u00ae as a diagnostic and therapeutic agent in the management of adhesive small bowel obstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic search of Medline, Embase and Cochrane databases was performed to identify studies of the use of Gastrografin\u00ae in adhesive small bowel obstruction. Studies that addressed the diagnostic role of water-soluble contrast agent were appraised, and data presented as sensitivity, specificity, and positive and negative likelihood ratios. Results were pooled and a summary receiver\u2013operator characteristic (ROC) curve was constructed. A meta-analysis of the data from six therapeutic studies was performed using the Mantel\u2013Haenszel test and both fixed- and random-effect models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The appearance of water-soluble contrast agent in the colon on an abdominal radiograph within 24 h of its administration predicted resolution of obstruction with a pooled sensitivity of 97 per cent and specificity of 96 per cent. The area under the summary ROC curve was 0\u00b798. Water-soluble contrast agent did not reduce the need for surgical intervention (odds ratio 0\u00b781, P = 0\u00b7300), but it did reduce the length of hospital stay for patients who did not require surgery compared with placebo (weighted mean difference \u2212 1\u00b784 days; P &amp;lt; 0\u00b7001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Published data strongly support the use of water-soluble contrast medium as a predictive test for non-operative resolution of adhesive small bowel obstruction. Although Gastrografin\u00ae does not reduce the need for operation, it appears to shorten the hospital stay for those who do not require surgery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bjs.5775","type":"journal-article","created":{"date-parts":[[2007,3,23]],"date-time":"2007-03-23T12:07:38Z","timestamp":1174651658000},"page":"404-411","source":"Crossref","is-referenced-by-count":95,"title":["Meta-analysis of oral water-soluble contrast agent in the management of adhesive small bowel obstruction"],"prefix":"10.1093","volume":"94","author":[{"given":"S M","family":"Abbas","sequence":"first","affiliation":[{"name":"Department of Surgery, Auckland University Hospital, Auckland 1023, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I P","family":"Bissett","sequence":"additional","affiliation":[{"name":"Department of Surgery, Auckland University Hospital, Auckland 1023, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B R","family":"Parry","sequence":"additional","affiliation":[{"name":"Department of Surgery, Auckland University Hospital, Auckland 1023, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2007,3,23]]},"reference":[{"key":"2021070911102774400_bib1","first-page":"40","article-title":"Small bowel obstruction due to postoperative adhesions: treatment patterns and associated costs in 110 hospital admissions","volume":"83","author":"Menzies","year":"2001","journal-title":"Ann R Coll Surg Engl"},{"key":"2021070911102774400_bib2","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/S0002-9610(00)00407-4","article-title":"Etiology of small bowel obstruction","volume":"180","author":"Miller","year":"2000","journal-title":"Am J Surg"},{"key":"2021070911102774400_bib3","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1111\/j.1445-2197.1993.tb00358.x","article-title":"The operative aetiology and types of adhesions causing small bowel obstruction","volume":"63","author":"Cox","year":"1993","journal-title":"Aust N Z J Surg"},{"key":"2021070911102774400_bib4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00000658-200207000-00002","article-title":"Therapeutic value of Gastrografin in adhesive small bowel obstruction after unsuccessful conservative treatment: a prospective randomized trial","volume":"236","author":"Choi","year":"2002","journal-title":"Ann Surg"},{"key":"2021070911102774400_bib5","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1080\/110241502321116488","article-title":"Early operation or conservative management of patients with small bowel obstruction?","volume":"168","author":"Fevang","year":"2002","journal-title":"Eur J Surg"},{"key":"2021070911102774400_bib6","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/S0002-9610(05)80414-3","article-title":"How conservatively can postoperative small bowel obstruction be treated?","volume":"165","author":"Seror","year":"1993","journal-title":"Am J Surg"},{"key":"2021070911102774400_bib7","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1111\/j.1445-2197.1993.tb00404.x","article-title":"The safety and duration of non-operative treatment of adhesive small bowel obstruction","volume":"63","author":"Cox","year":"1993","journal-title":"Aust N Z J Surg"},{"key":"2021070911102774400_bib8","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1093\/milmed\/162.11.749","article-title":"Contrast radiography in small bowel obstruction: a prospective, randomized trial","volume":"162","author":"Anderson","year":"1997","journal-title":"Mil Med"},{"key":"2021070911102774400_bib9","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1001\/archsurg.1984.01390230071017","article-title":"Roentgenographic contrast studies in acute small-bowel obstruction","volume":"119","author":"Dunn","year":"1984","journal-title":"Arch Surg"},{"key":"2021070911102774400_bib10","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1080\/110241501750070574","article-title":"Contrast radiography in small intestinal obstruction, a valuable diagnostic tool?","volume":"167","author":"Enochsson","year":"2001","journal-title":"Eur J Surg"},{"key":"2021070911102774400_bib11","first-page":"433","article-title":"Therapeutic effect of oral Gastrographin in adhesive, partial small bowel obstruction: a prospective randomized trial","volume":"115","author":"Assalia","year":"1994","journal-title":"Surgery"},{"key":"2021070911102774400_bib12","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1007\/s002689900622","article-title":"Oral urografin in postoperative small bowel obstruction","volume":"23","author":"Chen","year":"1999","journal-title":"World J Surg"},{"key":"2021070911102774400_bib13","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1177\/000313480006600303","article-title":"The use of water-soluble contrast in evaluating clinically equivocal small bowel obstruction","volume":"66","author":"Blackmon","year":"2000","journal-title":"Am Surg"},{"key":"2021070911102774400_bib14","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1111\/j.1445-2197.1996.tb00827.x","article-title":"A prospective study on the use of water-soluble contrast follow-through radiology in the management of small bowel obstruction","volume":"66","author":"Chung","year":"1996","journal-title":"Aust N Z J Surg"},{"key":"2021070911102774400_bib15","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/S0002-9610(97)89553-0","article-title":"Water-soluble contrast material has no therapeutic effect on postoperative small-bowel obstruction: results of a prospective, randomized clinical trial","volume":"171","author":"Feigin","year":"1996","journal-title":"Am J Surg"},{"key":"2021070911102774400_bib16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0197-2456(95)00134-4","article-title":"Assessing the quality of reports of randomized clinical trials: is blinding necessary?","volume":"17","author":"Jadad","year":"1996","journal-title":"Control Clin Trials"},{"key":"2021070911102774400_bib17","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1002\/sim.4780121403","article-title":"Combining independent studies of a diagnostic test into a summary ROC curve: data-analytic approaches and some additional considerations","volume":"12","author":"Moses","year":"1993","journal-title":"Stat Med"},{"key":"2021070911102774400_bib18","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1002\/bjs.4150","article-title":"Randomized clinical study of Gastrografin administration in patients with adhesive small bowel obstruction","volume":"90","author":"Biondo","year":"2003","journal-title":"Br J Surg"},{"key":"2021070911102774400_bib19","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/S0009-9260(02)00538-X","article-title":"Small bowel obstruction\u2014the water-soluble follow-through revisited","volume":"58","author":"Brochwicz-Lewinski","year":"2003","journal-title":"Clin Radiol"},{"key":"2021070911102774400_bib20","first-page":"422","article-title":"The value of water-soluble contrast radiology in the management of acute small bowel obstruction","volume":"74","author":"Joyce","year":"1992","journal-title":"Ann R Coll Surg Engl"},{"key":"2021070911102774400_bib21","first-page":"1576","article-title":"The value of contrast radiology for postoperative adhesive small bowel obstruction","volume":"49","author":"Onoue","year":"2002","journal-title":"Hepatogastroenterology"},{"key":"2021070911102774400_bib22","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1111\/j.1445-2197.2005.03491.x","article-title":"Randomized controlled trial of Gastrografin in adhesive small bowel obstruction","volume":"75","author":"Burge","year":"2005","journal-title":"ANZ J Surg"},{"key":"2021070911102774400_bib23","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1111\/j.1442-2034.2004.00224.x","article-title":"Water soluble contrast follow-through in the management of adhesive small bowel obstruction: a prospective randomized trial","volume":"8","author":"Lee","year":"2004","journal-title":"Ann Coll Surg H K"},{"key":"2021070911102774400_bib24","doi-asserted-by":"crossref","first-page":"2802","DOI":"10.3748\/wjg.v11.i18.2802","article-title":"Effect of water-soluble contrast in colorectal surgery: a prospective randomized trial","volume":"11","author":"Chen","year":"2005","journal-title":"World J Gastroenterol"},{"key":"2021070911102774400_bib25","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1080\/110241599750007180","article-title":"Venous intravasation of Gastrografin: a serious but underestimated complication","volume":"165","author":"Glauser","year":"1999","journal-title":"Eur J Surg"}],"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.5775","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/94\/4\/404\/36687272\/bjs5775.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/94\/4\/404\/36687272\/bjs5775.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T10:05:18Z","timestamp":1707732318000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/94\/4\/404\/6142683"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,3,23]]},"references-count":25,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2007,3,23]]},"published-print":{"date-parts":[[2007,3,23]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.5775","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2007,4]]},"published":{"date-parts":[[2007,3,23]]}}}