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

1. should not have delays in time to imaging as a result of prolonged intolerance to oral contrast
2. do not require the administration of oral contrast for the following indications:
   1. uncomplicated appendicitis or diverticulitis if BMI ~ 20
   2. suspected high-grade or severe bowel obstruction
   3. suspected aneurysm, dissection, or vessel thrombosis
   4. suspected bowel ischemia or infarct
   5. renal stone protocol orurograms
   6. pancreatic protocol for pancreatitis or mass
   7. liver protocol for liver mass or abscess
   8. adrenal protocol for adrenal mass or nodules
   9. superficial abdominal wall infections or abscesses
   10. inflammatory bowel disease
3. should have consideration of oral contrast based on their clinical history, current hemodynamic and oral tolerance status, and consultation with an attending emergency physician or radiology consultant for:
   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
4. should have oral contrast for the following indications:
   1. appendicitis or diverticulitis if.8MI <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

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