Pretreatment of Patients Requiring Oral Contrast Abdominal Computed Tomography With Antiemetics: A Randomized Controlled Trial of Efficacy

Garra, Gregory; Singer, Adam J.; Bamber, D. B.; Chohan, Jasmine; Troxell, Regina M.; Thode, Henry C.

doi:10.1016/j.annemergmed.2008.06.003

Cited by 8 publications

(4 citation statements)

References 9 publications

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“…The onset of pharmacological action of metoclopramide is 1 to 3 minutes following an intravenous dose, 10 to 15 minutes following intramuscular administration, and 20 to 60 minutes following an oral dose of two 10 mg tablets. Pharmacological effects persist for 1 to 2 hours [83,160].…”

Section: Metoclopramidementioning

confidence: 99%

Risk of Hypersensitivity Reactions to Iopromide After Intra-Arterial Versus Intravenous Administration

Endrikat¹,

Michel

Kölbach

et al. 2019

Invest Radiol

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This edition of the ACR Manual on Contrast Media replaces all earlier editions. It is being published as a webbased document only so it can be updated as frequently as needed.This manual was developed by the ACR Committee on Drugs and Contrast Media of the ACR Commission on Quality and Safety as a guide for radiologists to enhance the safe and effective use of contrast media. The Committee offers this document to practicing radiologists as a consensus of scientific evidence and clinical experience concerning the use of contrast media. Suggestions for patient screening, premedication, recognition of adverse reactions, and emergency treatment of such reactions are emphasized. Its major purpose is to provide useful information regarding contrast media used in daily practice.The editorial staff sincerely thanks all who have contributed their knowledge and valuable time to this publication.

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Section: Metoclopramidementioning

confidence: 99%

Risk of Hypersensitivity Reactions to Iopromide After Intra-Arterial Versus Intravenous Administration

Endrikat¹,

Michel

Kölbach

et al. 2019

Invest Radiol

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“…Oral contrast typically requires an observation period following its administration to allow opacification of the small bowel and passage of contrast into the colon [18] . Oral contrast resulted in delayed diagnosis and increased emergency department length of stay [19] . A frequent argument against oral contrast is that the diagnosis of SBO with CT can be made by the presence of secreted fluids and ingested air, which are already present in the bowel lumen and provide sufficient contrast [20] .…”

Section: Discussionmentioning

confidence: 99%

Value of MDCT Scan in Identifying Adhesive Small Bowel Obstruction and its Importance in Management Plan

RASHA MOSTAFA MOHAMED ALI, M.D.;

2023

The Medical Journal of Cairo University

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Background: Multi detector computed tomography (MD-CT) has become a mainstay in diagnosing bowel obstruction. Because the management of obstruction has dramatically changed with a decrease in the proportion of patients who need surgery, a precise CT evaluation is now both the gold standard and the common approach in patients with suspected bowel obstruction.Results: A total of 51 patients were eligible for inclusion in our study, all patients were admitted to emergency Department of Kasr Al-Ainy Teaching Hospital with clinical and radiological features of acute small bowel obstruction(ASBO). MDCT showed bowel obstruction in 40 (78.4%) patients, small bowel obstruction in 35 (68.6%) patients and large bowel obstruction in 5 (9.8%) patients, follow-up CT scan showed that contrast reached the large bowel obstruction was reported in 20 (41.7%) patients. Twelve (23.5%) patients were indicated for surgical intervention, ICU admission was reported in 3 (5.9%) patients, while one case showed leakage on day 1 post exploration. CT showed adhesions in 38 (74.5%) patients with final diagnosis of adhesive intestinal obstruction (IO) in 29 (56.9%) patients. Conclusion:We concluded that MDCT scan is a highly sensitive tool in detection of adhesive intestinal obstruction on the level of small and large bowel. MDCT scan can be used as a very accurate tool in screening for adhesive IO due to higher negative predictive value (100%).

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“…Oral contrast administration causes a diagnostic delay for the patient due to the time needed for ingestion of the contrast agent and gastrointestinal transport. In a randomized controlled trial by Garra et al, the median time to ingest 2 liters of an oral contrast agent was more than 100 minutes, potentially compromising individual patient safety in critical and timesensitive conditions [17]. Similarly, rectal contrast administration requires time, is dependent on patient compliance, and may aggravate patient discomfort (also as continence may be impaired, making adequate intraluminal filling improbable).…”

Section: Discussionmentioning

confidence: 99%

To Fill or Not to Fill? – Value of the Administration of Positive Rectal Contrast for CT Evaluation of Diverticular Disease of the Colon

Meyer

Schmidbauer

Wacker

et al. 2021

Rofo

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Purpose To assess the value of the administration of positive rectal contrast at CT in patients referred for suspected diverticular disease (DD) of the colon. Materials and Methods 460 patients (253 male, 207 female; median age 62 years; interquartile range 24) with clinical suspicion of DD of the colon were included in this retrospective IRB-approved study. CT was performed with i. v. contrast only (n = 328, group M1), i. v. + positive rectal contrast (n = 82, group M2), neither i. v. nor rectal contrast (n = 32, group S1), or positive rectal contrast only (n = 19, group S2). Two readers in consensus evaluated all CT datasets concerning diagnosis of DD (yes/no) and categorized findings (classification of diverticular disease (CDD)). Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values for the diagnosis of DD were calculated for all groups, using either clinical follow-up (n = 335) or intraoperative findings (n = 125) as the reference standard. In patients undergoing surgery, radiological staging of DD was correlated with the histopathology (weighted Cohen-k). Results 224 patients (48.7 %) were diagnosed with DD. The sensitivity, specificity, PPV, and NPV were as follows. Group M1 / M2: 92 %/92 %, 97 %/94 %, 96 %/96 %, 94 %/89 %, respectively; group S1 / S2: 94 %/86 %, 93 %/80 %, 94 %/92 %, 93 %/67 %, respectively. Radiological staging and histopathology correlated substantially in all groups (k = 0.748–0.861). Conclusion Abdominal CT had a high sensitivity and specificity for the diagnosis of DD. Disease staging correlated well with the findings at surgery. Additional positive rectal contrast administration did not have a significant advantage and may therefore be omitted in patients with suspected DD. Key Points: Citation Format

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Pretreatment of Patients Requiring Oral Contrast Abdominal Computed Tomography With Antiemetics: A Randomized Controlled Trial of Efficacy

Cited by 8 publications

References 9 publications

Risk of Hypersensitivity Reactions to Iopromide After Intra-Arterial Versus Intravenous Administration

Risk of Hypersensitivity Reactions to Iopromide After Intra-Arterial Versus Intravenous Administration

Value of MDCT Scan in Identifying Adhesive Small Bowel Obstruction and its Importance in Management Plan

To Fill or Not to Fill? – Value of the Administration of Positive Rectal Contrast for CT Evaluation of Diverticular Disease of the Colon

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