"A nasogastric tube must be in situ, and allowed to be on free suction for at least two hours prior to administration of the contrast to allow gastric decompression. Once the contrast has been administered, the nasogastric tube should be clamped for two hours. This ensures that the contrast is not immediately suctioned out of the stomach by the NG tube 1."
Expected headings
"Radiographic features"
"A 100 mL dose of water-soluble contrast, usually Gastrografin, is administered via a nasogastric tube, with abdominal radiographs acquired in the subsequent 24 hours. The findings can predict the need for operative management and determine whether the obstruction has resolved; seeing the contrast in the large bowel at 24 hours means the challenge has been successful and that the obstruction has been relieved. It is also considered to have a therapeutic effect; in theory, an increase in luminal fluid content via an osmotic effect may promote enough of a pressure gradient across the transition point to relieve the obstruction."
"A 100 mL dose of water-soluble contrast, usually Gastrografin, is administered via a nasogastric tube, with abdominal radiographs acquired in the subsequent 24 hours. The findings can predict the need for operative management and determine whether the obstruction has resolved; seeing the contrast in the large bowel at 24 hours means the challenge has been successful and that the obstruction has been relieved. It is also considered to have a therapeutic effect; in theory, an increase in luminal fluid content via an osmotic effect may promote enough of a pressure gradient across the transition point to relieve the obstruction."
"There is limited data on the use of the challenge in the setting of small bowel obstruction caused by something other than adhesions, such as hernias, as such, this is still considered to be a contraindication. The challenge has been used in the post-operative setting to differentiate between obstruction and ileus, although there is limited data on this."