Guy Stephen, Al Askari Mohammed
Griffith University, Gold Coast, Australia; Redland Hospital, Weippin Street, Cleveland, Queensland, 4163, Australia.
Redland Hospital, Weippin Street, Cleveland, Queensland, 4163, Australia.
Int J Surg Case Rep. 2017;33:51-54. doi: 10.1016/j.ijscr.2017.02.030. Epub 2017 Feb 21.
Adhesive small bowel obstruction (ASBO) is common after abdominal surgery. Water soluble contrast agents (WSCA) such as Gastrografin have been demonstrated to be safe and effective in predicting resolution of ASBO with conservative management while decreasing the time to resolution, decreasing the need for surgery and reducing overall length of stay. Few adverse effects have been reported. To the authors knowledge this is the first report of haemorrhagic gastritis following administration of Gastrografin for ASBO.
We present a case of haemorrhagic gastritis following Gastrografin administration in a 69-year-old male with adhesive small bowel obstruction who was managed conservatively with a good outcome. The report complies with the criteria outlined in the SCARE statement (Product Information Gastrografin [Product information], 2013).
The characteristics, mechanism of action, safety profile and efficacy of Gastrografin in ASBO are discussed along with the possible mechanisms underlying the haemorrhagic gastritis.
This patient at high risk of gastropathy experienced haemorrhagic gastritis following administration of Gastrografin for adhesive small bowel obstruction. WSCA such as Gastrografin are usually safe and effective in ASBO however caution may be warranted in patients at high risk of gastropathy.
粘连性小肠梗阻（ASBO）在腹部手术后很常见。水溶性造影剂（WSCA）如泛影葡胺已被证明在预测ASBO经保守治疗后缓解方面是安全有效的，同时可缩短缓解时间，减少手术需求并缩短总体住院时间。报告的不良反应很少。据作者所知，这是首例关于使用泛影葡胺治疗ASBO后发生出血性胃炎的报告。
我们报告一例69岁男性在使用泛影葡胺治疗粘连性小肠梗阻后发生出血性胃炎的病例，该患者经保守治疗取得了良好效果。本报告符合SCARE声明中概述的标准（泛影葡胺产品信息[产品信息]，2013年）。
讨论了泛影葡胺在ASBO中的特性、作用机制、安全性和疗效，以及出血性胃炎的可能潜在机制。
该具有胃病高风险的患者在使用泛影葡胺治疗粘连性小肠梗阻后发生了出血性胃炎。泛影葡胺等WSCA在ASBO中通常是安全有效的，但对于具有胃病高风险的患者可能需要谨慎使用。
