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. 2020 Aug;64(4):496-498.
doi: 10.1111/1754-9485.13053. Epub 2020 Jun 7.

Elimination of oral contrast leads to faster scans in the workup of abdominal pain in the emergency setting without compromising diagnostic accuracy

Jae-Kwan Jun  1 , Leon Shin-Han Winata  1 , Brendan Morrissey  2 , Tom Sutherland  1   3
Affiliations

Elimination of oral contrast leads to faster scans in the workup of abdominal pain in the emergency setting without compromising diagnostic accuracy

Jae-Kwan Jun et al. J Med Imaging Radiat Oncol. 2020 Aug.

Abstract

Introduction: The aim of this study was to study how the effect of eliminating oral contrast for computed tomography of the abdomen and pelvis (CTAP) in the workup of abdominal pain in the emergency department (ED) would affect the time from patient review to scan and time from review to discharge.

Methods: In this retrospective study, we analysed all ED presentations with abdominal pain to our university affiliated tertiary hospital before and after a protocol that eliminated oral contrast-enhanced CTAPs were implemented in September 2018. Two equivalent periods between September and November of 2017 and 2018 were analysed. Patients were excluded if they had a history of anatomy-altering gastrointestinal surgery, history of inflammatory bowel disease, trauma, suspicion of foreign body ingestion or suspected gastrointestinal bleeding.

Results: A total of 176 pre-protocol and 197 post-protocol patients were included in the study. We found that the elimination of oral contrast was associated with a decrease in mean time between ED review and scan by 110 min (379 vs. 269 min). We also found that the elimination of oral contrast did not significantly alter the pattern of radiological diagnoses seen between the two study periods, suggesting the absence of oral contrast does not affect diagnostic accuracy.

Conclusion: Thus, eliminating the use of oral contrast in the workup of abdominal pain in the ED can lead to increased throughput and more timely patient care.

Keywords: CT abdomen and pelvis; abdominal pain; emergency department; oral contrast; radiology.

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References

    1. Basile J, Kenny JF, Khodorkovsky B et al. Effects of eliminating routine use of oral contrast for computed tomography of the abdomen and pelvis: a pilot study. Clin Imaging. 2018; 49: 159-62.
    1. Lee SY, Coughlin B, Wolfe JM, Polino J, Blank FS, Smithline HA. Prospective comparison of helical CT of the abdomen and pelvis without and with oral contrast in assessing acute abdominal pain in adult Emergency Department patients. Emerg Radiol. 2006; 12: 150-7.
    1. Levenson RB, Camacho MA, Horn E, Saghir A, McGillicuddy D, Sanchez LD. Eliminating routine oral contrast use for CT in the emergency department: impact on patient throughput and diagnosis. Emerg Radiol. 2012; 19: 513-7.
    1. Kolbe AB, Fletcher JG, Froemming AT et al. Evaluation of patient tolerance and small-bowel distention with a new small-bowel distending agent for enterography. Am J Roentgenol. 2016; 206: 994-1002.
    1. Kessner R, Barnes S, Halpern P, Makrin V, Blachar A. CT for acute nontraumatic abdominal pain-is oral contrast really required? Acad Radiol. 2017; 24: 840-5.