Ultravist(R) Test in Postoperative Small Bowel Obstruction

PURPOSE: To determine whether Ultravist(R) test can enable the surgeon to differentiate complete from partial small bowel obstruction in patients with adhesive small bowel obstruction and whether partial small bowel obstruction can be treated nonoperatively. METHODS: Ninety-two patients who had postoperative small bowel obstructions without any toxic signs underwent Ultravist(R) test. Ultravist(R) (40 ml) mixed with 40 ml of distilled water was administrated either orally or via nasogastric tube to each patient. Serial plain abdominal radiographs were taken 4, 6, and 8 hours later. RESULTS: A total of 58 patients (63%) whose contrast medium reached the colon within the first 8 hours were considered to have partial obstruction (test positive) and were successfully treated with intravenous hydration and nasogastric decompression. The remaining 34 patients (36.9%), in whom the contrast medium failed to reach the colon within the first 8 hours (test negative), were regarded as having complete obstruction. Twenty-three of those patients (67.6%) underwent surgery and the other 11 (32.4%) received conservative treatment. Adhesion bands with complete bowel obstruction were observed in all 23 surgical patients during laparotomy. All the patients with partial bowel obstruction were treated successfully with nonoperative methods. Positive Ultravist(R) test as an indicator for nonoperative treatment had a sensitivity of 84.5%, a specificity of 100%, an accuracy of 88% and a false negative rate of 12%. CONCLUSION: Ultravist(R) can be used to differentiate partial from complete intestinal obstruction. All patients with evidence of Ultravist(R) reaching the colon within 8 hours were treated successfully with non-operative methods.

CT Contrast Enhancement in Infants : Observation of the Drug Application and Experience of Nursing / 实用放射学杂志

Objective To discuss drug application and nursing experience during CT contrast enhancement in infants.Methods CT contrast enhancement with Ultravist,one of the non-ionic contrast media,was performed on 202 infants.Before examination,all the infants were calmed with Diazepam or Chloral Hydrate(10% in concentration).The doses of the drugs were determined by the weight of these infants.Results Non-ionic contrast media was not absolutely safe and a few infants had side effects.Only 7 infants had positive allergic tests.The results of CT contrast enhancement on 202 infants were satisfied.Conclusion During CT enhancement,appropriate use of contrast media and sedatives as well as proper nursing according to the infants’ age will get a better result.