Faculty Collaboration Database

CT scan for suspected acute abdominal process: impact of combinations of IV, oral, and rectal contrast. World J Surg 2010 Apr;34(4):699-703

Date

01/08/2010

Pubmed ID

20054539

DOI

10.1007/s00268-009-0379-6

Scopus ID

2-s2.0-77952420658 (requires institutional sign-in at Scopus site)   43 Citations

Abstract

BACKGROUND There are limited data available on the ability of computed tomography (CT) to accurately diagnose abdominopelvic pathology in acutely ill inpatients suspected of having an acute abdominal process. The purpose of this study was to evaluate the diagnostic accuracy of abdominal/pelvic CT with varying use of contrast agents in hospitalized patients. METHODS A retrospective review of all hospital inpatients (3/1/07-5/31/07) who underwent urgent or emergent abdominal/pelvic CT with any combination of contrast, intravenous (IV), oral, rectal, or unenhanced for a suspected acute abdominal process was performed. Data collected included demographics, combination of contrast used, CT diagnosis, time from CT scan to subsequent intervention, intervention type, and actual diagnosis of the acute abdominal process. Accuracy of CT was compared between enhanced and unenhanced imaging using Fisher's exact test. RESULTS A total of 661 patients were identified. Use of IV contrast alone was found in 54.2% of CT scans and was correct in 92.5% of cases. IV and oral contrast was used in 22.2% of CT scans and was 94.6% correct. Unenhanced imaging was performed in 16.2% and was correct in 92.5%. Oral contrast alone was used in 7.0% and was 93.5% correct. There was no significant difference in the ability to correctly diagnose a suspected acute abdominal process when enhanced CT imaging was compared to unenhanced (p > 0.05). CONCLUSIONS CT contrast administration in critically ill hospitalized patients is not necessary to accurately diagnose an acute abdominal process. Eliminating the use of contrast may improve patient comfort, decrease patient risk, and minimize financial cost.

Author List

Hill BC, Johnson SC, Owens EK, Gerber JL, Senagore AJ

Author

Scott C. Johnson MD Associate Professor in the Urologic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Abdomen, Acute
Administration, Oral
Administration, Rectal
Aged
Analysis of Variance
Appendicitis
Chi-Square Distribution
Contrast Media
Diagnosis, Differential
Diverticulitis
Female
Humans
Injections, Intravenous
Male
Middle Aged
Retrospective Studies
Tomography, X-Ray Computed