Abdullah Alabousi MD, Presenter: Nothing to Disclose

Douglas S. Katz MD, Abstract Co-Author: Nothing to Disclose

Niv Sne MD, Abstract Co-Author: Nothing to Disclose

Michael Nathan Patlas MD, FRCPC, Abstract Co-Author: Nothing to Disclose

The purpose of the study was to validate the hypothesis that discontinuing the use of oral contrast (OC) for MDCT will not affect the detection of acute abdominal abnormalities in emergency room (ER) patients.

We conducted a retrospective study to assess the effect of eliminating OC use for 64MDCT scans of the abdomen and pelvis (AP) for patients presenting with acute abdominal pain to ER and BMI greater than 25. Patients with BMI less than 25 continued to receive OC. Only patients who underwent AP 64MDCT imaging in the portal venous phase without OC were included. The study was approved by the REB. Informed consent was waived. The electronic medical records were reviewed to determine the rate of repeat imaging within seven days from initial CT scan, as well as delayed or missed diagnoses related to the lack of OC.

1378 patients had an AP 64MDCT between November 1, 2012 and October 31, 2013. 375 patients met the inclusion criteria (174 males and 201 females, mean age 57, range 18-97). 7/375(1.9%) patients had repeat CT examination with OC within 7 days. Of these 7 patients, none had a change in the course of their management due to the utilization of OC. No delayed or missed diagnoses related to the lack of OC were identified.

Omitting OC for imaging patients with BMI greater than 25 presenting with acute abdominal pain in an ER setting resulted in no delayed or missed diagnoses. The benefits of prompt imaging diagnosis outweighs the minimal potential need for repeat imaging.

64MDCT evaluation of ER patients with acute abdominal pain can be safely performed without oral contrast.

Alabousi, A, Katz, D, Sne, N, Patlas, M, Is Oral Contrast Necessary for MDCT of Emergency Room Patients with Acute Abdominal Pain?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14000274.html