Abdominal Radiology

, Volume 43, Issue 11, pp 2945–2954 | Cite as

Small bowel obstruction and the gastrografin challenge

  • Robert D’AgostinoEmail author
  • Naiim S Ali
  • Sergey Leshchinskiy
  • Anjuli R Cherukuri
  • Judy K Tam
Pictorial essay


The “gastrografin challenge” has been used for decades in the evaluation of small bowel obstruction (SBO). This type of study involves enteric administration of a water-soluble contrast followed by serial abdominal radiographs. While its diagnostic role is well established, its therapeutic role remains controversial. Following an algorithm for gastrografin challenge cases can help with interpretation. An understanding of the appearance of diluted contrast in the small bowel, the concentrating effect of contrast in the colon, and knowledge of surgical history and anatomy is paramount for diagnosis. In this article, we review the approach to acute SBO and the use of gastrografin along with reviewing image interpretation of cases of partial and complete SBO. Gastrografin use in adynamic ileus along with other potential future uses is also discussed.


Gastrografin Small bowel obstruction Adhesions 


Compliance with ethical standards


No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Statement of informed consent was not applicable since the manuscript does not contain any patient data.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Robert D’Agostino
    • 1
    Email author
  • Naiim S Ali
    • 1
  • Sergey Leshchinskiy
    • 1
  • Anjuli R Cherukuri
    • 2
  • Judy K Tam
    • 1
  1. 1.Department of RadiologyUniversity of Vermont Medical Center, The University of Vermont Larner College of MedicineBurlingtonUSA
  2. 2.Department of RadiologyUniversity of Wisconsin, School of Medicine and Public HealthMadisonUSA

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