CT contrast media extravasation

Background

  • complication of contrast-enhanced CT scanning
    • may also occur from MRI, but rare given low volume used
  • Ultrasound-guided IVs are at higher risk[1]

Epidemiology

  • ~0.5% (range 0.13-0.68%) of cases

Clinical Features

  • Swelling and/or blistering at injection site

Differential Diagnosis

Contrast induced complications

Evaluation

  • Clinical (if no complication)

Management

  • Stop infusion immediately
  • Remove IV canula
  • Ice pack to affected area
  • Elevate
  • Consider hyaluronidase[2]

Complications

  • 97% have minimal or no injury
    • 79% have localized swelling after extravasation
    • 24% had pain
    • 8%
  • Large volumes (> 50 mL) of high-osmolar contrast media = highest risk

Disposition

May discharge after 2 hours with precautions if no signs of complications

See Also

External Links

References

  1. Dargin JM, Rebholz CM, Lowenstein RA, Mitchell PM, Feldman JA. Ultrasonography-guided peripheral intravenous catheter survival in ED patients with difficult access. Am J Emerg Med. 2010;28(1):1-7. doi:10.1016/j.ajem.2008.09.001
  2. https://pubmed.ncbi.nlm.nih.gov/22633726/