Oral contrast for abdominal and pelvic CT - Revision history

ClaireLewis at 14:58, 14 October 2019

2019-10-14T14:58:39Z

← Older revision		Revision as of 14:58, 14 October 2019
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	[[Category:Radiology]]		[[Category:Radiology]]
	[[Category:Renal]]		[[Category:Renal]]
			[[Category:Surgery]]

Mholtz at 00:39, 9 August 2018

2018-08-09T00:39:14Z

← Older revision		Revision as of 00:39, 9 August 2018
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	===May Consider===		===May Consider===
	*Suspected low-grade [[bowel obstruction]]<ref>American College of Radiology ACR Appropriateness Criteria® https://acsearch.acr.org/docs/69476/Narrative/</ref>		*Suspected low-grade [[bowel obstruction]]<ref name="ACR">American College of Radiology ACR Appropriateness Criteria® https://acsearch.acr.org/docs/69476/Narrative/</ref>
	**For suspected high-grade [[bowel obstruction]], oral contrast is contra-indicated (wastes time, adds expense, can induce further patient discomfort, will not add to diagnostic accuracy, and can lead to complications, particularly vomiting and aspiration)<ref~~>American College of Radiology~~ ACR ~~Appropriateness Criteria® https://acsearch.acr.org~~/~~docs/69476/Narrative/</ref~~>		**For suspected high-grade [[bowel obstruction]], oral contrast is contra-indicated (wastes time, adds expense, can induce further patient discomfort, will not add to diagnostic accuracy, and can lead to complications, particularly vomiting and aspiration)<ref name="ACR" />
	*Intra-abdominal [[abscess]] depending on the suspected primary source		*Intra-abdominal [[abscess]] depending on the suspected primary source
	**May not be required if primary source is skin infection		**May not be required if primary source is skin infection
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	*Suspected [[Hernia]]		*Suspected [[Hernia]]
	*[[Appendicitis]] or [[Diverticulitis]] with BMI <20		*[[Appendicitis]] or [[Diverticulitis]] with BMI <20
	**"Oral or rectal contrast may not be needed depending on institutional preference."<ref~~>American College of Radiology~~ ACR ~~Appropriateness Criteria® https://acsearch.acr.org/docs/69357~~/~~Narrative/</ref~~>		**"Oral or rectal contrast may not be needed depending on institutional preference."<ref name="ACR" />
	**"Evidence is trending against the routine use of oral contrast, and particularly against the routine use of rectal contrast, for CT when IV contrast is used."<ref~~>American College of Radiology~~ ACR ~~Appropriateness Criteria® https://acsearch.acr.org/docs/69357~~/~~Narrative/</ref~~>		**"Evidence is trending against the routine use of oral contrast, and particularly against the routine use of rectal contrast, for CT when IV contrast is used."<ref name="ACR" />

	==Redypaque Dose==		==Redypaque Dose==

Rossdonaldson1: /* Indications for Oral Contrast */

2018-06-26T20:52:55Z

Indications for Oral Contrast

← Older revision		Revision as of 20:52, 26 June 2018
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	==Indications for Oral Contrast==		==Indications for Oral Contrast==
	==="Desirable"===		===Desirable===
	*Suspected fistula or bowel leak		*Suspected fistula or bowel leak
	*Suspected [[intussusception]] or internal hernia		*Suspected [[intussusception]] or internal hernia

	==="May Consider"===		===May Consider===
	*Suspected low-grade [[bowel obstruction]]<ref>American College of Radiology ACR Appropriateness Criteria® https://acsearch.acr.org/docs/69476/Narrative/</ref>		*Suspected low-grade [[bowel obstruction]]<ref>American College of Radiology ACR Appropriateness Criteria® https://acsearch.acr.org/docs/69476/Narrative/</ref>
	**For suspected high-grade [[bowel obstruction]], oral contrast is contra-indicated (wastes time, adds expense, can induce further patient discomfort, will not add to diagnostic accuracy, and can lead to complications, particularly vomiting and aspiration)<ref>American College of Radiology ACR Appropriateness Criteria® https://acsearch.acr.org/docs/69476/Narrative/</ref>		**For suspected high-grade [[bowel obstruction]], oral contrast is contra-indicated (wastes time, adds expense, can induce further patient discomfort, will not add to diagnostic accuracy, and can lead to complications, particularly vomiting and aspiration)<ref>American College of Radiology ACR Appropriateness Criteria® https://acsearch.acr.org/docs/69476/Narrative/</ref>

Rossdonaldson1 at 20:52, 26 June 2018

2018-06-26T20:52:04Z

← Older revision		Revision as of 20:52, 26 June 2018
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	==Indications for Oral Contrast==		==Indications for Oral Contrast==
	==="Desirable"===		==="Desirable"===
	*[[Appendicitis]] or [[Diverticulitis]] with BMI <20
	**if CT indicated; consider immediate surgical consultation
	*Suspected fistula or bowel leak		*Suspected fistula or bowel leak
	*Suspected [[~~Intussusception~~]] or internal hernia		*Suspected [[intussusception]] or internal hernia

	==="May Consider"===		==="May Consider"===
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	*Metastatic evaluation		*Metastatic evaluation
	*Suspected [[Hernia]]		*Suspected [[Hernia]]
			*[[Appendicitis]] or [[Diverticulitis]] with BMI <20
			**"Oral or rectal contrast may not be needed depending on institutional preference."<ref>American College of Radiology ACR Appropriateness Criteria® https://acsearch.acr.org/docs/69357/Narrative/</ref>
			**"Evidence is trending against the routine use of oral contrast, and particularly against the routine use of rectal contrast, for CT when IV contrast is used."<ref>American College of Radiology ACR Appropriateness Criteria® https://acsearch.acr.org/docs/69357/Narrative/</ref>

	==Redypaque Dose==		==Redypaque Dose==

Rossdonaldson1: /* Indications for Oral Contrast */

2018-06-26T19:30:24Z

Indications for Oral Contrast

← Older revision		Revision as of 19:30, 26 June 2018
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	==="May Consider"===		==="May Consider"===
	*Suspected low-grade [[bowel obstruction]]		*Suspected low-grade [[bowel obstruction]]<ref>American College of Radiology ACR Appropriateness Criteria® https://acsearch.acr.org/docs/69476/Narrative/</ref>
	**For suspected high-grade [[bowel obstruction]], oral contrast is contra-indicated (wastes time, adds expense, can induce further patient discomfort, will not add to diagnostic accuracy, and can lead to complications, particularly vomiting and aspiration)<ref>American College of Radiology ACR Appropriateness Criteria® https://acsearch.acr.org/docs/69476/Narrative/</ref>		**For suspected high-grade [[bowel obstruction]], oral contrast is contra-indicated (wastes time, adds expense, can induce further patient discomfort, will not add to diagnostic accuracy, and can lead to complications, particularly vomiting and aspiration)<ref>American College of Radiology ACR Appropriateness Criteria® https://acsearch.acr.org/docs/69476/Narrative/</ref>
	*Intra-abdominal [[abscess]] depending on the suspected primary source		*Intra-abdominal [[abscess]] depending on the suspected primary source

Rossdonaldson1: /* Indications for Oral Contrast */

2018-06-26T19:29:44Z

Indications for Oral Contrast

← Older revision		Revision as of 19:29, 26 June 2018
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	==="May Consider"===		==="May Consider"===
	*Suspected low-grade [[bowel obstruction]]		*Suspected low-grade [[bowel obstruction]]
	**For suspected high-grade [[bowel obstruction]], oral contrast is contra-indicated (wastes time, adds expense, can induce further patient discomfort, will not add to diagnostic accuracy, and can lead to complications, particularly vomiting and aspiration)<ref>https://acsearch.acr.org/docs/69476/Narrative/ ~~American College of Radiology ACR Appropriateness Criteria®~~</ref>		**For suspected high-grade [[bowel obstruction]], oral contrast is contra-indicated (wastes time, adds expense, can induce further patient discomfort, will not add to diagnostic accuracy, and can lead to complications, particularly vomiting and aspiration)<ref>American College of Radiology ACR Appropriateness Criteria® https://acsearch.acr.org/docs/69476/Narrative/</ref>
	*Intra-abdominal [[abscess]] depending on the suspected primary source		*Intra-abdominal [[abscess]] depending on the suspected primary source
	**May not be required if primary source is skin infection		**May not be required if primary source is skin infection

Rossdonaldson1: /* Indications for Oral Contrast */

2018-06-26T19:29:12Z

Indications for Oral Contrast

← Older revision		Revision as of 19:29, 26 June 2018
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	*Suspected [[Intussusception]] or internal hernia		*Suspected [[Intussusception]] or internal hernia

	==="Consider"===		==="May Consider"===
	*Suspected low-grade [[bowel obstruction]]		*Suspected low-grade [[bowel obstruction]]
			**For suspected high-grade [[bowel obstruction]], oral contrast is contra-indicated (wastes time, adds expense, can induce further patient discomfort, will not add to diagnostic accuracy, and can lead to complications, particularly vomiting and aspiration)<ref>https://acsearch.acr.org/docs/69476/Narrative/ American College of Radiology ACR Appropriateness Criteria®</ref>
	*Intra-abdominal [[abscess]] depending on the suspected primary source		*Intra-abdominal [[abscess]] depending on the suspected primary source
	**May not be required if primary source is skin infection		**May not be required if primary source is skin infection

Rossdonaldson1 at 19:06, 26 June 2018

2018-06-26T19:06:29Z

← Older revision		Revision as of 19:06, 26 June 2018
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	*Cons: Requires significant "lead time" (i.e. must administer >1hr prior to CT scan) and can result in delays to care		*Cons: Requires significant "lead time" (i.e. must administer >1hr prior to CT scan) and can result in delays to care

	==Indications==		==Indications for Oral Contrast==
	===Desirable===		==="Desirable"===
	*[[Appendicitis]] or [[Diverticulitis]] with BMI <20		*[[Appendicitis]] or [[Diverticulitis]] with BMI <20
	**if CT indicated; consider immediate surgical consultation		**if CT indicated; consider immediate surgical consultation
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	*Suspected [[Intussusception]] or internal hernia		*Suspected [[Intussusception]] or internal hernia

	===Consider===		==="Consider"===
	*Suspected low-grade [[bowel obstruction]]		*Suspected low-grade [[bowel obstruction]]
	*Intra-abdominal [[abscess]] depending on the suspected primary source		*Intra-abdominal [[abscess]] depending on the suspected primary source
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	*Metastatic evaluation		*Metastatic evaluation
	*Suspected [[Hernia]]		*Suspected [[Hernia]]

	~~===Not Indicated===~~
	*Emergent process needing immediate CT
	*Delays in time to imaging due to prolonged intolerance of oral contrast
	*Uncomplicated [[Appendicitis]] or [[Diverticulitis]] with BMI >20
	*Suspected high-grade or severe [[bowel obstruction]]
	*Suspected aneurysm, dissection, or vessel thrombosis
	*Suspected bowel ischemia or infarct
	*[[Nephrolithiasis]] protocol
	*Pancreatic protocol for [[Pancreatitis]] or mass
	*Liver protocol for liver mass or abscess
	*Adrenal protocol for adrenal mass or nodules
	*Superficial abdominal wall infections or abscesses
	*[[Inflammatory bowel disease]]

	==Redypaque Dose==		==Redypaque Dose==

Rossdonaldson1 at 18:50, 26 June 2018

2018-06-26T18:50:57Z

← Older revision		Revision as of 18:50, 26 June 2018
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	*Superficial abdominal wall infections or abscesses		*Superficial abdominal wall infections or abscesses
	*[[Inflammatory bowel disease]]		*[[Inflammatory bowel disease]]


	==Redypaque Dose==		==Redypaque Dose==

Rossdonaldson1: /* Background */

2018-06-26T18:49:13Z

Background

← Older revision		Revision as of 18:49, 26 June 2018
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	*Pros: May add improved imaging characteristics for some patient groups		*Pros: May add improved imaging characteristics for some patient groups
	*Cons: Requires significant "lead time" (i.e. must administer >1hr prior to CT scan) and can result in delays to care		*Cons: Requires significant "lead time" (i.e. must administer >1hr prior to CT scan) and can result in delays to care


	==Indications==		==Indications==