Water for GI Contrast in Trauma CT

Abstract

Radiology| September 01 2004 Water for GI Contrast in Trauma CT AAP Grand Rounds (2004) 12 (3): 33. https://doi.org/10.1542/gr.12-3-33 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Water for GI Contrast in Trauma CT. AAP Grand Rounds September 2004; 12 (3): 33. https://doi.org/10.1542/gr.12-3-33 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: wounds and injuries, contrast media, diatrizoate Source: Halsted MJ, Racadio JM, Emery KH, et al. Oral contrast agents for CT of abdominal trauma in pediatric patients: a comparison of dilute Hypaque and water. Am J Roentgenol. 2004;182:1555–1559. A retrospective review from Cincinnati Children’s Hospital Medical Center, Ohio, scored the quality of visualization of bowel structures on 74 abdominal computed tomography (CT) scans of infants and children after blunt abdominal trauma. The study spanned a period in which the institution switched the oral contrast material for abdominal scanning from dilute Hypaque® to water. Of the CT scans observed, 53 were obtained with dilute Hypaque® and 21 with water. The age of the 2 groups was similar: dilute Hypaque®, 8.86 years; and water, 10.18 years. There was no difference in the visualization results of the contrast agents with respect to detection of intraabdominal abnormalities. As an oral contrast, water performed as well as dilute Hypaque® in facilitating visualization of all intraabdominal anatomic structures. Over the years in which CT evaluation of the abdomen has been performed after blunt abdominal trauma, a variety of positive oral contrast agents have been evaluated. Water serves as an effective negative contrast agent.1 Since any oral contrast agent poses a small risk of aspiration, there is reason to question the use of oral contrast agents of any kind after blunt abdominal trauma, but there is general agreement that the diagnostic value of CT is enhanced by oral contrast agents. Using water diminishes the risk of contrast-induced artifacts that limit visualization of detail in the region of the liver, spleen, and pancreas. Presumably water will also prove a safer agent if aspiration occurs. The risk of aspiration is low. In a series of 50 pediatric cases of blunt abdominal trauma, none of the patients exhibited overt clinical symptoms of aspiration and a chest CT indicated a silent aspiration in 1 child.2 There is a potential risk of aspiration in a neurologically compromised trauma patient.3 Other complications may occur: if Hypaque® is not correctly diluted, the mixture can be hypertonic and produce fluid shifts, which increases patient morbidity; and dilute Hypaque® may also produce CT artifacts. Unfortunately, only 1 investigator read all the films and could not be blinded to which contrast agent was used. In addition, the same patient could not be examined with a trial of Hypaque® and water since this would have subjected the patient to unnecessary radiation. Thus, we remain somewhat hesitant to fully accept the results until they have been confirmed by others. You do not currently have access to this content.