Oral contrast for abdominal and pelvic CT

Background

For patients undergoing CT of abdomen and/or pelvis

Redypaque Dose

Weight	Give 1 hour prior to scan	Give 30 minutes prior to scan	Give immediately upon arrival to CT
< 2 kg	None or as ordered by physician	None or as ordered by physician	None or as ordered by physician
2-5 kg	30 mL	30 mL	30 mL
>5-20 kg	90 mL	90 mL	90 mL
>20-50 kg	150 mL	150 mL	150 mL
>50 kg	300 mL	300 mL	300 mL

(100cc/age)/3 = dose x 3

Max = 300cc

Oral Contrast Indications

Desirable

• appendicitis or diverticulitis with BMI <20
  • if CT indicated; consider immediate surgical consultation
• intra-abdominal abscess with concern for a fistula or bowel leak
• suspected fistula or bowel leak
• suspected intussusception or internal hernia

Consider

• suspected low-grade bowel obstruction
• intra-abdominal abscess depending on the suspected primary source
  • may not be required if primary source is skin infection
• metastatic evaluation
• 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
• renal stone protocol orurograms
• 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

See Also

• Contrast with Renal Dysfunction
• Creatinine Screening for CT with Contrast

Source

• Harbor-UCLA Medical Center Guideline, "Emergency Department Oral Contrast Guidelines"
• American College of Emergency Physicians Guidelines
• American College of Radiology Guidelines
• Mink 7/2010