Perfused Intestine Gastrografin Study (PIGS) for water bead ingestion small bowel obstructions
Luke Pumiglia1, Brooklyn Williams1, Bobby Z Zhang1
1Madigan Army Medical Center, USA.
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 cm of perfused porcine bowel. Experimental animals (n = 3, 24 WBs) received 50 mL of GG. Controls (n = 3, 24 WBs) received 50 mL of tap water. WBs dwelled for 3 h before extraction.
Results:
WBs that dwelled with GG decreased in diameter significantly compared to controls (-30.3 % vs -18 %; p < 0.01). This was conserved on subgroup analyses of 2 sizes of WBs made by 2 manufacturers (-25.35 % vs -10.9 %, p < 0.01; -33.4 % vs -22.6 %, p < 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.
