Oral contrast for abdominal and pelvic CT

Background

• Oral contrast considerations for patients undergoing CT of abdomen and/or pelvis
• 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

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

Indications

Desirable

• Appendicitis or Diverticulitis with BMI <20
  • if CT indicated; consider immediate surgical consultation
• 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
• 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

See Also

• Contrast-induced nephropathy
• Creatinine screening prior to IV contrast