Roentgenographic contrast studies in acute small-bowel obstruction.

Plain abdominal roentgenograms are usually adequate for the treatment of patients with small-bowel obstruction. There is a select group of patients who may benefit from a more precise diagnosis or by nonoperative therapy for whom contrast roentgenograms may be helpful. Contrast roentgenograms were performed in 68 (21%) of 327 patients who had nondiagnostic abdominal films, atypical histories or findings, or those in whom nonoperative resolution would be highly desirable. Sixty-eight percent of 48 contrast tracers gave useful information, whereas 75% of 24 contrast enemas were helpful. Contrast material passed through a site of obstruction in 34 patients, yet 13 (38%) still required an operation. Contrast material did not pass in 16 patients and only one avoided a surgical procedure. No difference was noted between barium sulfate or water-soluble contrast material or how it was administered.