Limitations and dangers of gastrografin swallow after esophageal and upper gastric operations

• Published in: The American journal of surgery Vol. 155; no. 3; pp. 495 - 497
• Main Authors: Fan, S T, Lau, W Y, Yip, W C, Poon, G P, Yeung, C, Wong, K K
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier 01.03.1988
• Subjects: Anastomosis, Surgical - adverse effects; Biological and medical sciences; Colon - surgery; Diatrizoate Meglumine - adverse effects; Digestive system; Esophagus - surgery; Humans; Investigative techniques, diagnostic techniques (general aspects); Jejunum - surgery; Medical sciences; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiography; Stomach - surgery; Surgical Wound Dehiscence - diagnostic imaging; Surgical Wound Dehiscence - etiology; Human; Radiography; Stomach; Surgery; Risk factor; Digestive diseases; Complication; ENT disease; Contrast media; Esophagus
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/s0002-9610(88)80121-1

In a series of 135 patients who underwent esophageal and upper stomach surgery, the incidence of anastomotic leakage was 20.4 percent. One hundred four patients had either Gastrografin swallow or the methylene blue test to evaluate anastomotic integrity before resumption of oral feeding. Both tests were disappointing in that methylene blue failed to detect any case of leakage and Gastrografin swallow could only detect three cases of subclinical leakage. The high false-negative detection rate of Gastrografin swallow might be related to the inferior radiographic detail provided by this contrast medium. Aspiration of Gastrografin is potentially dangerous and could be fatal. We believe that barium sulfate, which provides better radiographic detail and is not so hazardous when aspirated, should be the contrast medium of choice.