Oral contrast for abdominal and pelvic CT
Background
For patients undergoing CT of abdomen and/or pelvis
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
Oral Contrast Indications
Desirable
- appendicitis or diverticulitis with BMI <20
- intra-abdominal abscess with concern for a fistula or bowel leak
- suspected fistula or bowel leak
- suspected intussusception or internal hernia
Consider
- suspected low-grade bowel obstruction
- intra-abdominal abscess depending on the suspected primary source (eg, may not be required if primary source is skin infection)
- metastatic evaluation
- suspected hernia
Not Indicated
- emergent process needing immediate CT
- delays in time to imaging due to prolonged intolerance of oral contrast
- uncomplicated appendicitis or diverticulitis with BMI >20
- suspected high-grade or severe bowel obstruction
- suspected aneurysm, dissection, or vessel thrombosis
- suspected bowel ischemia or infarct
- renal stone protocol orurograms
- pancreatic protocol for pancreatitis or mass
- liver protocol for liver mass or abscess
- adrenal protocol for adrenal mass or nodules
- superficial abdominal wall infections or abscesses
- inflammatory bowel disease
Source
- Harbor-UCLA Medical Center Guideline, "Emergency Department Oral Contrast Guidelines"
- American College of Emergency Physicians Guidelines
- American College of Radiology Guidelines
- Mink 7/2010