[Studies of selective non-surgical therapy in perforated duodenal ulcer indicated by gastrografin test]

One hundred ml of Gastrografin was administered through the gastric tube to each of ten subjects with duodenal ulcer perforation and to each of twenty subjects which had no gastrointestinal perforation. Urine was collected from the subjects every 10 minutes up to 180 minutes following the administration of gastrogratin. The iodine level of every urine sample was assayed using inductively coupled plasma atomic emission spectrometry. The iodine level of seven subjects with open duodenal ulcer perforation was higher than the mean +2 = SD of urine from the subjects without gastrointestinal perforations. Two of the subjects had no leakage of Gastrografin demonstrated intra-abdominally during an upper gastrointestinal series. The urine iodine level of subjects with closed duodenal perforation was lower than the mean +2 X SD of urine from the subjects without gastrointestinal perforations. One of the subjects was selected non-surgical therapy, and two other subjects which underwent emergent surgery may also have been candidates for non-surgical therapy, as suggested by its indications. The above results suggest that patients with duodenal ulcer perforation but without intra-abdominal leakage of Gastrografin and urine iodine level lower than the mean +2 X SD of urine from subjects without gastrointestinal perforation following Gastrografin administration may be selectable for non-surgical therapy.