Oral contrast for abdominal and pelvic CT: Difference between revisions
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==Background== | ==Background== | ||
* | *Oral contrast considerations for patients undergoing CT of abdomen and/or pelvis | ||
*Requires significant "lead time" | *Pros: May add improved imaging characteristics for some patient groups | ||
*Cons: Requires significant "lead time" (i.e. must administer >1hr prior to CT scan) and can result in delays to care | |||
==Indications for Oral Contrast== | |||
===Desirable=== | |||
*Suspected fistula or bowel leak | |||
*Suspected [[intussusception]] or internal hernia | |||
===May Consider=== | |||
*Suspected low-grade [[bowel obstruction]]<ref name="ACR">American College of Radiology ACR Appropriateness Criteria® https://acsearch.acr.org/docs/69476/Narrative/</ref> | |||
**For suspected high-grade [[bowel obstruction]], oral contrast is contra-indicated (wastes time, adds expense, can induce further patient discomfort, will not add to diagnostic accuracy, and can lead to complications, particularly vomiting and aspiration)<ref name="ACR" /> | |||
*Intra-abdominal [[abscess]] depending on the suspected primary source | |||
**May not be required if primary source is skin infection | |||
*Metastatic evaluation | |||
*Suspected [[Hernia]] | |||
*[[Appendicitis]] or [[Diverticulitis]] with BMI <20 | |||
**"Oral or rectal contrast may not be needed depending on institutional preference."<ref name="ACR" /> | |||
**"Evidence is trending against the routine use of oral contrast, and particularly against the routine use of rectal contrast, for CT when IV contrast is used."<ref name="ACR" /> | |||
==Redypaque Dose== | ==Redypaque Dose== | ||
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Max = 300cc | Max = 300cc | ||
==See Also== | ==See Also== | ||
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[[Category:Radiology]] | [[Category:Radiology]] | ||
[[Category:Renal]] | [[Category:Renal]] | ||
[[Category:Surgery]] |
Latest revision as of 14:58, 14 October 2019
Background
- Oral contrast considerations for patients undergoing CT of abdomen and/or pelvis
- Pros: May add improved imaging characteristics for some patient groups
- Cons: Requires significant "lead time" (i.e. must administer >1hr prior to CT scan) and can result in delays to care
Indications for Oral Contrast
Desirable
- Suspected fistula or bowel leak
- Suspected intussusception or internal hernia
May Consider
- Suspected low-grade bowel obstruction[1]
- For suspected high-grade bowel obstruction, oral contrast is contra-indicated (wastes time, adds expense, can induce further patient discomfort, will not add to diagnostic accuracy, and can lead to complications, particularly vomiting and aspiration)[1]
- Intra-abdominal abscess depending on the suspected primary source
- May not be required if primary source is skin infection
- Metastatic evaluation
- Suspected Hernia
- Appendicitis or Diverticulitis with BMI <20
Redypaque Dose
Weight |
Give 1 hour prior to scan |
Give 30 minutes prior to scan |
Give immediately upon arrival to CT |
< 2 kg |
None or as ordered by physician |
None or as ordered by physician |
None or as ordered by physician |
2-5 kg |
30 mL |
30 mL |
30 mL |
>5-20 kg |
90 mL |
90 mL |
90 mL |
>20-50 kg |
150 mL |
150 mL |
150 mL |
>50 kg |
300 mL |
300 mL |
300 mL |
(100cc/age)/3 = dose x 3
Max = 300cc
See Also
References
- ↑ 1.0 1.1 1.2 1.3 American College of Radiology ACR Appropriateness Criteria® https://acsearch.acr.org/docs/69476/Narrative/