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Use of oral contrast material in abdominal trauma CT scans: is it dangerous?
M P Federle1, A Peitzman, J Krugh
1Department of Radiology, University of Pittsburgh Medical Center, Presbyterian University Hospital, Pennsylvania 15213, USA.
Objective:
To determine the potential risks of the use of oral contrast medium for bowel opacification in abdominal trauma computed tomography (CT) scanning.
Design:
A retrospective chart review.
Materials And Methods:
506 consecutive patients who had CT evaluation of acute blunt abdominal trauma. All had both intervenous and "oral" administration of iodinated contrast material. Alert cooperative patients drank 450 ml of a 2.5% solution of Gastroview, while obtunded or uncooperative patients had the same volume and concentration of medium administered through a nasogastric tube, following endotracheal intubation.
Results:
No patients had aspiration of the contrast medium or gastric contents attributable to performance of the CT scan, except for one patient who had inadvertent installation of contrast through a tube that had been placed into the right main bronchus rather than the stomach.
Conclusions:
Bowel opacification is important for optimal CT evaluation of abdominal trauma and can be used with confidence. Attention to proper preparation and administration of the contrast material and, more importantly, control of the patient's airway by appropriate tracheal intubation are essential to assure the safety of the procedure.