Serum diatrizoate level during intraoperative cholangiography in patients without choledochal obstructions

To assess the degree of regurgitation of contrast media during intraoperative cholangiography, serum diatrizoate levels were measured in 15 patients without demonstrable bile duct obstructions. The maximum pressure achieved during the injection was measured in seven cases and ranged from 13 to 39 cm H2O (average 21.7 +/- 9.3 cm H2O). Only two of the 15 patients studied had detected serum diatrizoate (in one patient 7-14 micrograms I/ml and the other patient 119-200 micrograms I/ml) after completion of the injection. The data suggest that regurgitation of contrast media into the blood during intraoperative cholangiography does not depend solely on injection pressure. Moreover the data suggest that in order to prevent adverse reactions to accidental intravenous contrast administration nonionic contrast media should be used in most, if not all, radiographic studies as some contrast media reaches the bloodstream.