Abstract
The diagnosis of small bowel obstruction (SBO) by abdominal computed tomography previously often included both intravenous and oral contrast agents. Recent guidelines suggest that oral contrast agents (gastrografin, barium) are unnecessary, as they significantly delay diagnosis, falsely enhance adjacent bowel wall, and do not provide benefit over air and secreted fluids already in the bowel lumen. The administration of intravenous contrast in suspected SBO is beneficial and allows the provider to assess for bowel wall ischemia.
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References
Paulson EK, Thompson WM. Review of small-bowel obstruction: the diagnosis and when to worry. Radiology. 2015;275(2):332ā42.
Garra G, Singer AJ, Bamber D, Chohan J, Troxell R, Thode HC Jr. Pretreatment of patients requiring oral contrast abdominal computed tomography with antiemetics: a randomized controlled trial of efficacy. Ann Emerg Med. 2009;53:528ā33.
Furukawa A, Yamasaki M, Takahashi M, Nitta N, Tanaka T, Yokoyama K, Murata K, Sakamoto T. CT diagnosis of small bowel obstruction: scanning technique, interpretation and role in the diagnosis. Semin Ultrasound CT MR. 2003;24(5):336ā52.
National Guideline Clearinghouse (NGC). Guideline summary: ACR Appropriateness CriteriaĀ® suspected small-bowel obstruction. In: National Guideline Clearinghouse (NGC). Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); 2013. [cited 2017 Jul 17]. Available: https://www.guideline.gov
Broder JS, Hamedani AG, Liu SW, Emerman CL. Emergency department contrast practices for abdominal/pelvic computed tomography-a national survey and comparison with the American College of Radiology Appropriateness Criteria. J Emerg Med. 2013;44:423ā33.
Atri M, McGregor C, McInnes M, Power N, Rahnavardi K, Law C, Kiss A. Multidetector helical CT in the evaluation of acute small bowel obstruction: comparison of non-enhanced (no oral, rectal or IV contrast) and IV enhanced CT. Eur J Radiol. 2009;71:135ā40.
Sheedy SP, Earnest F, Fletcher JG, Fidler JL, Hoskin TL. CT of small-bowel ischemia associated with obstruction in emergency department patients: diagnostic performance evaluation. Radiology. 2006;241:729ā36.
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Gettel, C., Cummings, C. (2019). So I amĀ Getting a CT for Small Bowel Obstruction, Do I Need Oral Contrast? IV Contrast?. In: Graham, A., Carlberg, D.J. (eds) Gastrointestinal Emergencies. Springer, Cham. https://doi.org/10.1007/978-3-319-98343-1_49
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DOI: https://doi.org/10.1007/978-3-319-98343-1_49
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