Oral contrast solution and computed tomography for blunt abdominal trauma: a randomized study

Area of Science:

• Radiology
• Trauma Surgery
• Emergency Medicine

Background:

• Computed tomography (CT) is crucial for evaluating blunt abdominal trauma.
• The role of oral contrast solution (OC) in acute abdominal CT scans for trauma is debated.
• Optimizing CT protocols can improve efficiency and patient outcomes in trauma care.

Purpose of the Study:

• To determine if oral contrast solution (OC) is necessary for the acute computed tomographic (CT) evaluation of patients with blunt abdominal trauma.
• To assess the impact of OC on the detection of gastrointestinal and solid organ injuries.
• To evaluate the effect of OC on the time required for CT scanning.

Main Methods:

• A randomized controlled clinical trial was conducted at a Level I trauma center.
• 394 adult patients with blunt abdominal trauma were randomized to receive either OC or no OC after nasogastric tube placement.
• All patients underwent helical CT scans of the abdomen and pelvis with intravenous contrast.

Main Results:

• No significant difference in vomiting incidence between groups.
• The group without OC had a 100% sensitivity for detecting small-bowel injuries compared to 86% with OC.
• Specificity for solid organ injury was lower in the no OC group (57.1%) versus the OC group (94%).
• CT scanning time was significantly shorter in the no OC group (average 39 minutes) compared to the OC group (average 46 minutes).

Conclusions:

• Oral contrast solution (OC) is unnecessary in the acute CT evaluation of blunt abdominal trauma.
• Administering OC delays the time to CT scanning without improving the detection of significant injuries.
• Current CT protocols for blunt abdominal trauma can be optimized by omitting OC.