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

=Desirable

1. appendicitis or diverticulitis with BMI <20
2. intra-abdominal abscess with concern for a fistula or bowel leak
3. suspected fistula or bowel leak
4. suspected intussusception or internal hernia

Consider

1. suspected low-grade bowel obstruction
2. intra-abdominal abscess depending on the suspected primary source (eg, may not be required if primary source is skin infection)
3. metastatic evaluation
4. suspected hernia

Not Indicated

1. emergent process needing immediate CT
2. delays in time to imaging due to prolonged intolerance of oral contrast
3. uncomplicated appendicitis or diverticulitis with BMI >20
4. suspected high-grade or severe bowel obstruction
5. suspected aneurysm, dissection, or vessel thrombosis
6. suspected bowel ischemia or infarct
7. renal stone protocol orurograms
8. pancreatic protocol for pancreatitis or mass
9. liver protocol for liver mass or abscess
10. adrenal protocol for adrenal mass or nodules
11. superficial abdominal wall infections or abscesses
12. inflammatory bowel disease

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