The aim of this investigation has been to find a safe and
suitable contrast medium for radiological evaluation of the
gastrointestinal tract in cases where leakage outside the GIT
can be suspected. Leakage outside the gastro-intestinal tract
lumen can occur in many ways eg., spontaneously, due to a
disease process, iatrogenically or postoperatively at the site
of anastomosis. The contrast medium used for the radiological
evaluation of such patients could leak outside the
lumen of the GIT and enter the mediastinum, pleura,
peritoneum or bronchi and lungs. It is therefore essential to
use a contrast medium, which would be safe should it leak
into one or more of the regions mentioned. An experimental
study was carried out to evaluate the reactions of various
available CM in the bronchi and lungs, mediastinum, pleura
and peritoneum of rats. The CM evaluated in the
experimental study were, pure barium sulphate (without any
additives), commercial barium sulphate (Micropaque, with
additives), Dionosil, Hytrast, Gastrografin, Amipaque (in
pleura Omnipaque) and Hexabrix.
The results of all the experiments taken together show that
lower osmolality contrast media Hexabrix, Amipaque and
Omnipaque are safer than all other CM examined experimentally,
for radiological evaluation of leakage from the
GIT. The clinical use of Hexabrix was started ± 4 years ago
for the examination of suspected UGIT leakage and has, so
far, shown no untoward or negative effects.
The aim and introduction in Chapter 1 are followed by
various aspects of the contrast media in chapters 2 and 3.
Chapter 4 deals with the aetiology of leakage, experimental
investigation, clinical experience and method of radiological
evaluation of gastrointestinal tract leakage. Chapters 5, 6, 7,
8 and 9 deal comprehensively with the experimental study.
The clinical use of Hexabrix in the UGIT is described in
chapter 10. The general discussion and conclusions are
given in chapter 11