SynthesisBJS open2025
Water-soluble contrast agents in adhesional small bowel obstruction: meta-analysis and PRECIS-2 assessment of trials.
Synthesis in BJS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed.
- A conceptual roadmap towards precision emergency surgery in adhesional small bowel obstruction.The British journal of surgery · 2026Article
- Review
- Endoscopic Management of Post-Bariatric Surgery Complications: Diagnostic Work-Up and Innovative Approaches for Leak, Fistula, and Stricture Management.Diagnostics (Basel, Switzerland) · 2026Review
- Dogma, data, and decision-making: a history of treatment for small-bowel obstruction.World journal of emergency surgery : WJES · 2026Review
- Evidence-based, cost-effective management of small bowel obstruction: An algorithm of the Journal of Trauma and Acute Care Surgery emergency general surgery algorithms work group.The journal of trauma and acute care surgery · 2025Article
- Global burden of paralytic ileus and intestinal obstruction, 1990-2021: a GBD 2021 analysis.Journal of health, population, and nutrition · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdhesional small bowel obstruction is a common presentation to acute general surgical services. Initial management is typically conservative and includes the use of water-soluble contrast agents. Current trials assessing water-soluble contrast agents are limited by sample size and demonstrate contrasting results. The aim of this review was to systematically appraise the use of water-soluble contrast agents in adhesional small bowel obstruction.
methodsThis systematic review and meta-analysis was registered with PROSPERO (CRD42024573136) and conducted in line with PRISMA guidelines. Searches of Medline, Embase and Central databases were undertaken to include randomized clinical trials reporting the use of water-soluble contrast agents in adhesional small bowel obstruction. Searches were last updated on 26 July 2024. The primary outcome was the need for operative intervention. Secondary outcomes included the rate of intestinal ischaemia, the need for bowel resection, and mortality. A random-effects meta-analysis was conducted for outcomes reported in three or more studies. Risk of bias was assessed using the Cochrane Risk-of-Bias tool, and trial methods were appraised using the PRagmatic Explanatory Continuum Indicator Summary (PRECIS-2) tool.
resultsIn all, 11 randomized controlled trials were included with a median sample size of 88 (range 26-242), nine of which were single-centre studies; only one study used computed tomography imaging to diagnoses adhesional small bowel obstruction. Meta-analysis revealed no significant difference in operative intervention (odds ratio 0.63, 95% confidence interval 0.39 to 1.01; P = 0.053), small bowel ischaemia, small bowel resection, or mortality. Risk of bias raised concerns in several domains. PRECIS-2 assessment showed trials were pragmatic rather than explanatory designs.
conclusionThis review does not support the use of therapeutic water-soluble contrast agents in adhesional small bowel obstruction. Further adequately powered trials are needed. Standardization of diagnostic modality and consideration of explanatory designs should be considered.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.