title: Oral contrast for CT in patients with acute non-traumatic abdominal and pelvic pain: what should be its current role?
abstract: Positive oral contrast agents, including barium suspensions and water-soluble iodinated solutions, have traditionally been used in conjunction with the CT evaluation of patients with abdominal and pelvic pain. Due to continued advancements in CT technology, and due to increasing obesity and correspondingly a general increase in the intra-abdominal and intra-pelvic fat separating bowel loops in North American patients and in patients in other parts of the world over the past few decades, the ability of radiologists to accurately evaluate the cause of acute symptoms has substantially improved. Recent research and evolving imaging society guidelines/systematic reviews increasingly support performing CT scans of the abdomen and pelvis without the need for positive oral contrast in these types of adult patient populations, in most clinical situations. Increased patient throughput, patient preference, patient safety, and most importantly, retention of high diagnostic accuracy, are reasons for this recent change in practice to routinely omit the use of enteric contrast agents for the majority of patients presenting with acute abdominal and pelvic pain whom are undergoing emergency CT.
authors.affiliation: Ottawa Hospital Research Institute, The Ottawa Hospital, 1053 Carling Ave, Ottawa, Ontario, Canada.
authors.forename: Ania Z
authors.initials: AZ
authors.lastname: Kielar
authors.affiliation: Division of Emergency/Trauma Radiology, Department of Radiology, McMaster University, Hamilton, Ontario, Canada. patlas@hhsc.ca.|Radiology, Hamilton General Hospital, 237 Barton St. East, Hamilton, ON, L8L 2X2, Canada. patlas@hhsc.ca.
authors.forename: Michael N
authors.initials: MN
authors.lastname: Patlas
authors.affiliation: Department of Radiology, Winthrop-University Hospital, Mineola, NY, USA.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Katz
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging*; D000284:Administration, Oral; D003287:Contrast Media / Q000008:administration & dosage*; D006801:Humans; D017699:Pelvic Pain / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: Abdominal and pelvic pain; Computed tomography; Diagnostic accuracy; Emergency radiology; Oral contrast