[Is the use of hyperosmolar oral contrast media still justifiable today?]

The application of oral hyperosmolar contrast media, as they are used for the control of anastomoses after operations on the upper intestinal tract and for the diagnosis of ileus, is still controversial today because of possible side effects. We examined 53 patients postoperatively, after abdominal operations and within the framework of the diagnosis of ileus, to find out whether there were any problems with the fluid and electrolyte balance, and whether side-effects such as nausea, vomiting, pain and diarrhoea were still tolerable. The patients did not classify their subjective complaints as very serious. None of our patients showed clinically manifest disorders of the fluid and electrolyte balance. The increased frequency of bowel movement, caused by the contrast agent, was required for the treatment of postoperative bowel atonia and the condition of ileus or sub-ileus, if present. We still think the application of hyperosmolar contrast media can be justified, and hence we restrict the use of the much more expensive iso-osmolar contrast agents to patients who are at risk in respect to aspiration and unfit to cooperate.