There were no major or minor complications in the study, and with a 0% complication rate and a confidence interval of 0 to 3.6%, this was significantly below our pre-set acceptable complication rate of 5%.
Over the last two decades, water-soluble contrast agents in management of small bowel obstructions have become well established in adult literature given their ability to predict success of non-operative management.
Over the last two decades, water-soluble contrast agents in management of small bowel obstructions have become well established in adult literature given their ability to predict success of non-operative management
quoteAdhesive small bowel obstructions are a well-known cause of morbidity in children following abdominal surgery.↗
▶Ep 2 · 1:33
clinicalAdhesive small bowel obstructions are a well-known cause of morbidity in children following abdominal surgery.↗
▶Ep 2 · 1:50
clinicalTraditional treatment for adhesive small bowel obstruction has been gastric decompression, bowel rest, fluid resuscitation, and electrolyte replacement.↗
▶Ep 2 · 2:05
clinicalOver the last two decades, water-soluble contrast agents in management of small bowel obstructions have become well established in adult literature given their ability to predict success of non-operative management.↗
▶Ep 2 · 2:25
clinicalIn the contrast challenge protocol, after gastric decompression the patient is given contrast and an abdominal X-ray is obtained 8 to 10 hours later. Contrast in the colon indicates passing the challenge.↗
▶Ep 2 · 2:55
clinicalPatients without contrast in colon after repeat X-ray at 24 hours are considered to have failed the contrast challenge and are taken to surgery for exploration.↗
▶Ep 2 · 3:15
epidemiologicalLimited data exists regarding safety and use of contrast challenge in the pediatric population, yet multiple pediatric institutions have adopted contrast challenge algorithms.↗
▶Ep 2 · 3:45
clinicalThe study performed retrospective review of all children undergoing contrast challenge across 5 children's hospitals over 8 years.↗
▶Ep 2 · 4:00
clinicalPrimary outcome was any complication related to contrast administration, with complication rate less than 5% considered safe for clinical practice by group consensus.↗
▶Ep 2 · 4:20
clinicalMajor complications were defined as aspiration, pneumonia, anaphylaxis, cardiovascular complications, and renal failure. Minor complications included urticaria, dyspnea, and worsening abdominal pain.↗
▶Ep 2 · 4:40
clinical82 children underwent contrast challenge. 57 initially passed, of which 53 had clinical improvement and were successfully discharged. 25 failed and were taken to surgery.↗
▶Ep 2 · 4:40
clinicalThe group that failed contrast challenge had significantly longer hospital stay by 5 days.↗
▶Ep 2 · 4:55
clinical6 patients were readmitted within 30 days for recurrent small bowel obstruction.↗
▶Ep 2 · 5:00
clinicalThere was significant age difference between groups, with those passing the challenge a median of 7 years older, but no differences between each age group.↗
▶Ep 2 · 5:05
clinicalThe contrast challenge has sensitivity of 100%, specificity of 86%, negative predictive value of 100%, and positive predictive value of 93%.↗
▶Ep 2 · 5:15
epidemiologicalOver 30% of patients had neurologic and pulmonary comorbidities.↗
▶Ep 2 · 5:25
clinicalContrast agents used were institution-specific with relatively similar osmolality, with dilute gastrographin being most commonly utilized.↗
▶Ep 2 · 5:30
quoteIn our review of 82 patients, which is the largest to date in children, we demonstrated that a contrast challenge is safe, effective, and highly predictive in children and provides informative data for the surgeon to use in their clinical decision making.↗
▶Ep 2 · 5:30
clinicalThis review of 82 patients is the largest to date in children demonstrating that contrast challenge is safe, effective, and highly predictive.↗
▶Ep 2 · 5:40
quoteThere were no major or minor complications in the study, and with a 0% complication rate and a confidence interval of 0 to 3.6%, this was significantly below our pre-set acceptable complication rate of 5%.↗
▶Ep 2 · 5:40
clinicalThere were no major or minor complications in the study, with 0% complication rate and confidence interval of 0 to 3.6%, significantly below the pre-set acceptable rate of 5%.↗
▶Ep 2 · 5:55
clinicalThere were no mortalities in either group.↗
▶Ep 2 · 6:59
clinicalEvery institution had similar protocol that had been mirrored to Dr. Grace Mack from University of Chicago's study from 2018.↗
▶Ep 2 · 7:25
clinicalThe Midwest Pediatric Surgery Consortium is conducting a prospective study looking at contrast challenges in pediatric adhesive small bowel obstruction.↗
▶Ep 2 · 7:55
opinionMore pediatric surgeons have adopted the practice after seeing it was safe and effective in predicting which children will be successfully managed non-operatively.↗
APSA - A contrast challenge is safe in children with adhesive small bowel obstruction- a multi-institutional review - Nathan Rubalcava
▶Ep 3 · 0:33
quoteAdhesive small bowel obstructions are a well-known cause of morbidity in children following abdominal surgery.↗
▶Ep 3 · 0:33
clinicalAdhesive small bowel obstructions are a well-known cause of morbidity in children following abdominal surgery↗
▶Ep 3 · 1:00
clinicalTraditional treatment for adhesive small bowel obstruction has been gastric decompression, bowel rest, fluid resuscitation, and electrolyte replacement↗
▶Ep 3 · 1:20
clinicalOver the last two decades, water-soluble contrast agents in management of small bowel obstructions have become well established in adult literature given their ability to predict success of non-operative management↗
▶Ep 3 · 1:45
clinicalA contrast challenge is performed after a period of gastric decompression, with abdominal X-ray obtained 8 to 10 hours after contrast administration↗
▶Ep 3 · 2:10
clinicalContrast in the colon is considered having passed the contrast challenge, and patients are discharged after demonstrating clinical improvement with tolerance of regular diet↗
▶Ep 3 · 2:30
clinicalPatients without contrast in colon after repeat abdominal X-ray at 24 hours are considered to have failed their contrast challenge and are taken to surgery for exploration↗
▶Ep 3 · 2:50
epidemiologicalLimited data exists regarding safety and use of contrast challenge in the pediatric population, despite multiple pediatric institutions adopting contrast challenge algorithms↗
▶Ep 3 · 3:10
clinicalThe study performed retrospective review of all children undergoing contrast challenge across 5 children's hospitals over 8 years↗
▶Ep 3 · 3:30
clinicalBy group consensus, a complication rate less than 5% would be considered safe to use a contrast challenge for clinical practice↗
▶Ep 3 · 3:45
clinicalMajor complications were defined as aspiration, pneumonia, anaphylaxis, cardiovascular complications, and renal failure; minor complications included urticaria, dyspnea, and worsening abdominal pain↗
▶Ep 3 · 4:05
epidemiological82 children underwent a contrast challenge; 57 initially passed with 53 having clinical improvement and successful discharge; 25 failed and were taken to surgery↗
▶Ep 3 · 4:25
epidemiologicalThere was a significant age difference between groups, with those passing the challenge being a median of 7 years older, but no differences between each age group↗
▶Ep 3 · 4:40
epidemiologicalOver 30% of patients had neurologic and pulmonary comorbidities↗
▶Ep 3 · 4:50
clinicalContrast agents used were institution-specific with relatively similar osmolality, with dilute gastrographin being the most commonly utilized agent↗
▶Ep 3 · 5:05
quoteThere were no major or minor complications in the study, and with a 0% complication rate and the confidence interval of 0 to 3.6%, this was significantly below our pre-set acceptable complication rate of 5%.↗
▶Ep 3 · 5:05
epidemiologicalThere were no major or minor complications in the study, with a 0% complication rate and confidence interval of 0 to 3.6%, significantly below the pre-set acceptable complication rate of 5%↗
▶Ep 3 · 5:25
epidemiologicalThere were no mortalities in either group↗
▶Ep 3 · 5:30
epidemiologicalThe group that failed their contrast challenge had a significantly longer hospital stay by 5 days↗
▶Ep 3 · 5:40
epidemiologicalA total of 6 patients were readmitted within 30 days for recurrent small bowel obstruction↗
▶Ep 3 · 5:50
epidemiologicalThe contrast challenge has a sensitivity of 100%, specificity of 86%, negative predictive value of 100%, and positive predictive value of 93%↗
▶Ep 3 · 5:57
clinicalEvery institution had a similar protocol that had been mirrored to Doctor Grace Mack from University of Chicago's study from 2018↗
▶Ep 3 · 6:15
quoteIn our review of 82 patients, which is the largest to date in children, we demonstrated that a contrast challenge is safe, effective, and highly predictive in children and provides informative data for the surgeon to use in their clinical decision making.↗
▶Ep 3 · 6:15
epidemiologicalThis review of 82 patients is the largest to date in children demonstrating that a contrast challenge is safe, effective, and highly predictive in children↗
▶Ep 3 · 6:25
clinicalThe Midwest Pediatric Surgery Consortium is conducting a prospective study looking at contrast challenges in pediatric adhesive small bowel obstruction↗
▶Ep 3 · 6:50
opinionMore pediatric surgeons have adopted the practice after the study showed it was safe and effective in predicting which children will be successfully managed non-operatively↗
quoteAdhesive small bowel obstructions are a well-known cause of morbidity in children following abdominal surgery.↗
▶Ep 2 · 1:33
clinicalAdhesive small bowel obstructions are a well-known cause of morbidity in children following abdominal surgery.↗
▶Ep 2 · 1:50
clinicalTraditional treatment for adhesive small bowel obstruction has been gastric decompression, bowel rest, fluid resuscitation, and electrolyte replacement.↗
▶Ep 2 · 2:05
clinicalOver the last two decades, water-soluble contrast agents in management of small bowel obstructions have become well established in adult literature given their ability to predict success of non-operative management.↗
▶Ep 2 · 2:25
clinicalIn the contrast challenge protocol, after gastric decompression the patient is given contrast and an abdominal X-ray is obtained 8 to 10 hours later. Contrast in the colon indicates passing the challenge.↗
▶Ep 2 · 2:55
clinicalPatients without contrast in colon after repeat X-ray at 24 hours are considered to have failed the contrast challenge and are taken to surgery for exploration.↗
▶Ep 2 · 3:15
epidemiologicalLimited data exists regarding safety and use of contrast challenge in the pediatric population, yet multiple pediatric institutions have adopted contrast challenge algorithms.↗
▶Ep 2 · 3:45
clinicalThe study performed retrospective review of all children undergoing contrast challenge across 5 children's hospitals over 8 years.↗
▶Ep 2 · 4:00
clinicalPrimary outcome was any complication related to contrast administration, with complication rate less than 5% considered safe for clinical practice by group consensus.↗
▶Ep 2 · 4:20
clinicalMajor complications were defined as aspiration, pneumonia, anaphylaxis, cardiovascular complications, and renal failure. Minor complications included urticaria, dyspnea, and worsening abdominal pain.↗
▶Ep 2 · 4:40
clinical82 children underwent contrast challenge. 57 initially passed, of which 53 had clinical improvement and were successfully discharged. 25 failed and were taken to surgery.↗
▶Ep 2 · 4:40
clinicalThe group that failed contrast challenge had significantly longer hospital stay by 5 days.↗
▶Ep 2 · 4:55
clinical6 patients were readmitted within 30 days for recurrent small bowel obstruction.↗
▶Ep 2 · 5:00
clinicalThere was significant age difference between groups, with those passing the challenge a median of 7 years older, but no differences between each age group.↗
▶Ep 2 · 5:05
clinicalThe contrast challenge has sensitivity of 100%, specificity of 86%, negative predictive value of 100%, and positive predictive value of 93%.↗
▶Ep 2 · 5:15
epidemiologicalOver 30% of patients had neurologic and pulmonary comorbidities.↗
▶Ep 2 · 5:25
clinicalContrast agents used were institution-specific with relatively similar osmolality, with dilute gastrographin being most commonly utilized.↗
▶Ep 2 · 5:30
quoteIn our review of 82 patients, which is the largest to date in children, we demonstrated that a contrast challenge is safe, effective, and highly predictive in children and provides informative data for the surgeon to use in their clinical decision making.↗
▶Ep 2 · 5:30
clinicalThis review of 82 patients is the largest to date in children demonstrating that contrast challenge is safe, effective, and highly predictive.↗
▶Ep 2 · 5:40
quoteThere were no major or minor complications in the study, and with a 0% complication rate and a confidence interval of 0 to 3.6%, this was significantly below our pre-set acceptable complication rate of 5%.↗
▶Ep 2 · 5:40
clinicalThere were no major or minor complications in the study, with 0% complication rate and confidence interval of 0 to 3.6%, significantly below the pre-set acceptable rate of 5%.↗
▶Ep 2 · 5:55
clinicalThere were no mortalities in either group.↗
▶Ep 2 · 6:59
clinicalEvery institution had similar protocol that had been mirrored to Dr. Grace Mack from University of Chicago's study from 2018.↗
▶Ep 2 · 7:25
clinicalThe Midwest Pediatric Surgery Consortium is conducting a prospective study looking at contrast challenges in pediatric adhesive small bowel obstruction.↗
▶Ep 2 · 7:55
opinionMore pediatric surgeons have adopted the practice after seeing it was safe and effective in predicting which children will be successfully managed non-operatively.↗
APSA - A contrast challenge is safe in children with adhesive small bowel obstruction- a multi-institutional review - Nathan Rubalcava
▶Ep 3 · 0:33
clinicalAdhesive small bowel obstructions are a well-known cause of morbidity in children following abdominal surgery↗
▶Ep 3 · 0:33
quoteAdhesive small bowel obstructions are a well-known cause of morbidity in children following abdominal surgery.↗
▶Ep 3 · 1:00
clinicalTraditional treatment for adhesive small bowel obstruction has been gastric decompression, bowel rest, fluid resuscitation, and electrolyte replacement↗
▶Ep 3 · 1:20
clinicalOver the last two decades, water-soluble contrast agents in management of small bowel obstructions have become well established in adult literature given their ability to predict success of non-operative management↗
▶Ep 3 · 1:45
clinicalA contrast challenge is performed after a period of gastric decompression, with abdominal X-ray obtained 8 to 10 hours after contrast administration↗
▶Ep 3 · 2:10
clinicalContrast in the colon is considered having passed the contrast challenge, and patients are discharged after demonstrating clinical improvement with tolerance of regular diet↗
▶Ep 3 · 2:30
clinicalPatients without contrast in colon after repeat abdominal X-ray at 24 hours are considered to have failed their contrast challenge and are taken to surgery for exploration↗
▶Ep 3 · 2:50
epidemiologicalLimited data exists regarding safety and use of contrast challenge in the pediatric population, despite multiple pediatric institutions adopting contrast challenge algorithms↗
▶Ep 3 · 3:10
clinicalThe study performed retrospective review of all children undergoing contrast challenge across 5 children's hospitals over 8 years↗
▶Ep 3 · 3:30
clinicalBy group consensus, a complication rate less than 5% would be considered safe to use a contrast challenge for clinical practice↗
▶Ep 3 · 3:45
clinicalMajor complications were defined as aspiration, pneumonia, anaphylaxis, cardiovascular complications, and renal failure; minor complications included urticaria, dyspnea, and worsening abdominal pain↗
▶Ep 3 · 4:05
epidemiological82 children underwent a contrast challenge; 57 initially passed with 53 having clinical improvement and successful discharge; 25 failed and were taken to surgery↗
▶Ep 3 · 4:25
epidemiologicalThere was a significant age difference between groups, with those passing the challenge being a median of 7 years older, but no differences between each age group↗
▶Ep 3 · 4:40
epidemiologicalOver 30% of patients had neurologic and pulmonary comorbidities↗
▶Ep 3 · 4:50
clinicalContrast agents used were institution-specific with relatively similar osmolality, with dilute gastrographin being the most commonly utilized agent↗
▶Ep 3 · 5:05
quoteThere were no major or minor complications in the study, and with a 0% complication rate and the confidence interval of 0 to 3.6%, this was significantly below our pre-set acceptable complication rate of 5%.↗
▶Ep 3 · 5:05
epidemiologicalThere were no major or minor complications in the study, with a 0% complication rate and confidence interval of 0 to 3.6%, significantly below the pre-set acceptable complication rate of 5%↗
▶Ep 3 · 5:25
epidemiologicalThere were no mortalities in either group↗
▶Ep 3 · 5:30
epidemiologicalThe group that failed their contrast challenge had a significantly longer hospital stay by 5 days↗
▶Ep 3 · 5:40
epidemiologicalA total of 6 patients were readmitted within 30 days for recurrent small bowel obstruction↗
▶Ep 3 · 5:50
epidemiologicalThe contrast challenge has a sensitivity of 100%, specificity of 86%, negative predictive value of 100%, and positive predictive value of 93%↗
▶Ep 3 · 5:57
clinicalEvery institution had a similar protocol that had been mirrored to Doctor Grace Mack from University of Chicago's study from 2018↗
▶Ep 3 · 6:15
epidemiologicalThis review of 82 patients is the largest to date in children demonstrating that a contrast challenge is safe, effective, and highly predictive in children↗
▶Ep 3 · 6:15
quoteIn our review of 82 patients, which is the largest to date in children, we demonstrated that a contrast challenge is safe, effective, and highly predictive in children and provides informative data for the surgeon to use in their clinical decision making.↗
▶Ep 3 · 6:25
clinicalThe Midwest Pediatric Surgery Consortium is conducting a prospective study looking at contrast challenges in pediatric adhesive small bowel obstruction↗
▶Ep 3 · 6:50
opinionMore pediatric surgeons have adopted the practice after the study showed it was safe and effective in predicting which children will be successfully managed non-operatively↗
