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

  1. appendicitis or diverticulitis with BMI <20
  2. intra-abdominal abscess with concern for a fistula or bowel leak
  3. suspected fistula or bowel leak
  4. suspected intussusception or internal hernia

Consider

  1. suspected low-grade bowel obstruction
  2. intra-abdominal abscess depending on the suspected primary source (eg, may not be required if primary source is skin infection)
  3. metastatic evaluation
  4. suspected hernia

Not Indicated

  1. emergent process needing immediate CT
  2. delays in time to imaging due to prolonged intolerance of oral contrast
  3. uncomplicated appendicitis or diverticulitis with BMI >20
  4. suspected high-grade or severe bowel obstruction
  5. suspected aneurysm, dissection, or vessel thrombosis
  6. suspected bowel ischemia or infarct
  7. renal stone protocol orurograms
  8. pancreatic protocol for pancreatitis or mass
  9. liver protocol for liver mass or abscess
  10. adrenal protocol for adrenal mass or nodules
  11. superficial abdominal wall infections or abscesses
  12. 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