Perfused Intestine Gastrografin Study (PIGS) for water bead ingestion small bowel obstructions.

Abstract

BACKGROUND: Water beads (WBs) are commonly ingested by children and may expand causing obstruction often requiring surgery. Gastrografin (GG) has been shown to reduce WB diameter ex-vivo and in-vitro. We studied the impact of GG on diameters of WBs in an in-vivo model of porcine bowel. METHODS: 48 expanded WBs were placed into 45 &#x200b;cm of perfused porcine bowel. Experimental animals (n &#x200b;= &#x200b;3, 24 WBs) received 50 &#x200b;mL of GG. Controls (n &#x200b;= &#x200b;3, 24 WBs) received 50 &#x200b;mL of tap water. WBs dwelled for 3 &#x200b;h before extraction. RESULTS: WBs that dwelled with GG decreased in diameter significantly compared to controls (-30.3 &#x200b;% vs -18 &#x200b;%; p &#x200b;< &#x200b;0.01). This was conserved on subgroup analyses of 2 sizes of WBs made by 2 manufacturers (-25.35 &#x200b;% vs -10.9 &#x200b;%, p &#x200b;< &#x200b;0.01; -33.4 &#x200b;% vs -22.6 &#x200b;%, p &#x200b;< &#x200b;0.01). CONCLUSION: Gastrografin significantly reduced WB size in a perfused bowel model and may have a role as a non-operative adjunct in managing pediatric WB ingestions.