Extravasation of nonionic radiologic contrast media: efficacy of conservative treatment

The authors report four large-volume (greater than 20-mL) extravasations in adults and one intermediate-volume (18-mL) extravasation in an infant of iopamidol, a nonionic contrast medium, that occurred during dynamic enhanced computed tomography. The largest volume that extravasated (in two patients) was 150 mL. Although all five patients initially had swelling, erythema, and/or pain after extravasation, all recovered uneventfully. The authors suggest that emergent surgical drainage of all large-volume extravasations, a procedure that was recently recommended, is unnecessary. Large extravascular collections of nonionic contrast media can be well tolerated and are often resorbed without adverse sequelae.