Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jun 28, 2023; 15(6): 191-200
Published online Jun 28, 2023. doi: 10.4329/wjr.v15.i6.191
Role of contrast-enhanced serial/spot abdominal X-rays in perioperative follow-up of patients undergoing abdominal surgery: An observational clinical study
Osman Nuri Dilek, Arif Atay, Orgun Gunes, Furkan Karahan, Şebnem Karasu
Osman Nuri Dilek, Arif Atay, Furkan Karahan, Department of Surgery, İzmir Katip Celebi University, School of Medicine, İzmir 35150, Turkey
Orgun Gunes, Department of Surgery, İzmir Atatürk Education and Research Hospital, İzmir 35150, Turkey
Şebnem Karasu, Department of Radiology, İzmir Katip Celebi University, School of Medicine, İzmir 35150, Turkey
Author contributions: Dilek ON was the designer of the study and revised the article critically for scientific content and collected the images; Güneş Ö and Atay A participated in the acquisition, analysis, and interpretation of the data, and drafted the initial manuscript; Karahan F and Karasu Ş collected and reported the patients’ data and images.
Institutional review board statement: The study was carried out in accordance with the principles of the Helsinki Declaration. As a routine procedure, written informed consent was obtained from each patient for all procedures and publications. Ethics committee approval was received for this study (2022/GOKAE/0542) from the Clinical Trials Ethics Committee.
Informed consent statement: All study participants, or their legal guardians, provided informed written consent before study enrollment. The data used in this study did not involve the patients’ privacy information, so the informed consent was waived by the Ethics Committee of University Hospital. All patient data obtained, recorded, and managed were only used for this study, and all patient information is strictly confidential, without any harm to the patient.
Conflict-of-interest statement: All of the authors declare that there are no conflicts of interest in connection with this paper, and the material described is not under publication or consideration for publication elsewhere.
Data sharing statement: All of the authors declare that there are no shared data in this paper, and the material described is not under publication or consideration for publication elsewhere.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Osman Nuri Dilek, FACS, Professor, Surgeon, Department of Surgery, İzmir Katip Celebi University, School of Medicine, Basın Sitesi, İzmir 35150, Turkey. osmannuridilek@gmail.com
Received: March 13, 2023
Peer-review started: March 13, 2023
First decision: May 9, 2023
Revised: May 17, 2023
Accepted: June 16, 2023
Article in press: June 16, 2023
Published online: June 28, 2023
Processing time: 106 Days and 20 Hours
Abstract
BACKGROUND

Many imaging methods such as ultrasonography, computed tomography (CT), magnetic resonance imaging, and endoscopy are used to identify the problems or complications that occur in the perioperative period and to determine the appropriate therapeutic approach. Specialists at surgical clinics and intensive care units sometimes need diagnostic procedures that can give quick results or reveal unexpected results. In particular, rapid on-site evaluation of patients followed under intensive care conditions has several advantages.

AIM

To determine the problems developing in patients in the perioperative period by contrast-enhanced abdominal X-ray (CE-AXR), revealing their current status or defining the effectiveness of CE-AXR.

METHODS

The files of the patients who underwent hepatopancreatobiliary or upper gastrointestinal surgery, whose CE-AXR film was taken, were reviewed retrospectively. Abdominal X-ray radiographs taken after ingestion of a water-soluble contrast agent (iohexol, 300 mg, 50 cc vial) and its application in a drain, nasogastric tube, or stent were evaluated. The contribution of the data obtained in patients who underwent CE-AXR to the diagnosis, follow-up, and treatment processes and the effectiveness of the application were investigated.

RESULTS

CE-AXR was applied to 131 patients in our clinic, most of whom underwent hepatopancreatobiliary or upper gastrointestinal surgery. It was determined that the data obtained from CE-AXR films taken in 98 (74.8%) of the patients contributed to the diagnosis, treatment, and follow-up expectations and positively affected the clinical processes.

CONCLUSION

CE-AXR is a simple procedure that can be applied anywhere, especially in intensive care patients and at bedside, with a portable X-ray device. The simplicity of the procedure, less radiation exposure for the patients, less time wastage, reduction in the CT and endoscopy procedure burden and costs, quick results, rapid assessment of the situation, and enabling the monitoring of processes with repetitive procedures are important advantages. X-rays taken will be useful in terms of being a reference value during the follow-up period of the patient and determining the situation in medicolegal processes.

Keywords: Abdominal X-rays, Contrast medium, Diagnosis, Complication, Leakage, Radiation exposure

Core Tip: Specialists at surgical clinics and and intensive care units sometimes need diagnostic procedures that can give quick results or reveal unexpected results. In this study, contrast-enhanced abdominal X-ray (CE-AXR) was used to evaluate diagnosis and treatment efficacy in 131 patients. We sought to determine the problems developing in patients in the perioperative period, revealing their current condition or defining the effectiveness of CE-AXR. It was found that CE-AXR accelerated and facilitated decision-making processes in selected patient groups and did not require further investigation. It was determined that the data obtained from CE-AXR contributed to the diagnosis, treatment, and follow-up expectations in 98 patients (74.8%) and also had a positive impact on clinical processes. CE-AXR is a procedure that can be performed almost anywhere with a portable X-ray machine, particularly at bedside, and in intensive care units and clinics.