title: Renal excretion of water-soluble contrast media after enema in the neonatal period.
abstract: BACKGROUND
  When abdominal distention occurs or bowel obstruction is suspected in the neonatal period, a water-soluble contrast enema is helpful for diagnostic and therapeutic purposes. The water-soluble contrast medium is evacuated through the anus as well as excreted via the kidneys in some babies. This study was designed to evaluate the incidence of renal excretion after enemas using water-soluble contrast media and presume the causes.
  
  
  METHODS
  Contrast enemas using diluted water-soluble contrast media were performed in 23 patients under 2 months of age. After the enema, patients were followed with simple abdominal radiographs to assess the improvement in bowel distention, and we could also detect the presence of renal excretion of contrast media on the radiographs. Reviewing the medical records and imaging studies, including enemas and consecutive abdominal radiographs, we evaluated the incidence of renal excretion of water-soluble contrast media and counted the stay duration of contrast media in urinary tract, bladder, and colon.
  
  
  RESULTS
  Among 23 patients, 12 patients (52%) experienced the renal excretion of water-soluble contrast media. In these patients, stay-in-bladder durations of contrast media were 1-3 days and stay-in-colon durations of contrast media were 1-10 days, while stay-in-colon durations of contrast media were 1-3 days in the patients not showing renal excretion of contrast media. The Mann-Whitney test for stay-in-colon durations demonstrated the later evacuation of contrast media in the patients with renal excretion of contrast media (p = 0.07). The review of the medical records showed that 19 patients were finally diagnosed as intestinal diseases, including Hirschsprung's disease, meconium ileum, meconium plug syndrome, and small bowel atresia or stenosis. Fisher's exact test between the presence of urinary excretion and intestinal diseases indicated a statistically significant difference (p = 0.04).
  
  
  CONCLUSIONS
  The intestinal diseases causing bowel obstruction may increase the water-soluble contrast media's dwell time in the bowel and also increase urinary excretion.
authors.affiliation: Department of Radiology, Korea University Hospital, Ansan, Gyeonggido, Republic of Korea.
authors.forename: Hee Sun
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Radiology, Korea University Hospital, Ansan, Gyeonggido, Republic of Korea. Electronic address: radje@korea.ac.kr.
authors.forename: Bo-Kyung
authors.initials: BK
authors.lastname: Je
authors.affiliation: Department of Radiology, Korea University Hospital, Ansan, Gyeonggido, Republic of Korea.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Cha
authors.affiliation: Department of Pediatrics, Korea University Hospital, Ansan, Gyeonggido, Republic of Korea.
authors.forename: Byung Min
authors.initials: BM
authors.lastname: Choi
authors.affiliation: Department of Radiology, Korea University Hospital, Ansan, Gyeonggido, Republic of Korea.
authors.forename: Ki Yeol
authors.initials: KY
authors.lastname: Lee
authors.affiliation: Department of Radiology, Korea University Hospital, Ansan, Gyeonggido, Republic of Korea.
authors.forename: Seung Hwa
authors.initials: SH
authors.lastname: Lee
mesh_terms: D003287:Contrast Media / Q000493:pharmacokinetics*; D003974:Diatrizoate Meglumine / Q000493:pharmacokinetics*; D004733:Enema; D005260:Female; D006627:Hirschsprung Disease / Q000000981:diagnostic imaging; D006801:Humans; D007231:Infant, Newborn; D007409:Intestinal Atresia / Q000000981:diagnostic imaging; D007410:Intestinal Diseases / Q000000981:diagnostic imaging*; D007421:Intestine, Small / Q000002:abnormalities / Q000000981:diagnostic imaging; D008297:Male; D008470:Meconium; D011860:Radiography, Abdominal; D065667:Renal Elimination
chemical_list: D003287:Contrast Media; D003974:Diatrizoate Meglumine
keywords: contrast enema; contrast media; diatrizoate meglumine; ileus; infant; intestinal obstruction; newborn; renal excretion; water-soluble iodinated