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Oral Contrast

question1. Why do we use oral contrast?
question2. What kind of oral contrast do we use?
question3. When do we use positive agents and when do we use neutral agents?
question4. What are the advantages of oral LOCM (Omnipaque)?
question5. Is there any contraindication to the use of oral contrast?
question6. If a patient has had a prior reaction to IV contrast can we still use oral contrast?
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7. Part 1: When does the patient get the oral contrast relative to the time the patients get the actual CT scan?

Part 2: Does this differ between inpatients and outpatients?

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8. Are there any other oral contrasts that are used?

question9. Can you use a single bottle of Omnipaque -350 at multiple time points by drawing 10-20 cc at a time to use to mix oral contrast?
question10. What is VoLumen and when do you use it?
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Theoretically result in better bowel distention than water. Because it contains Sorbitol some patients will experience diarrhea when used. Patients should be warned about this before leaving the Radiology department.

Usually either 2 or 3 premixed volumes are given (450 ml each) and the patient needs to drink it over a 30 minute period. Each bottle should be drunk over 10 minute period. When all 3 are drunk (at 30 minutes) the CT study is done promptly using IV contrast material often as a CT Enterography study with CT Angiography.

CT Enterography: Protocol

  • 450 ml pre-mixed bottles
  • rotocols involve the patient drinking either 900 ml or 1350 ml
  • Sequence is

    450 ml VoLumen0-10 minutes
    450 ml VoLumen10-20 minutes
    450 ml VoLumen20-30 minutes

Normal Duodenum

Normal DuodenumNormal Duodenum

Dilated SB with VoLumen

Dilated SB with VoLumenDilated SB with VoLumen

Adenomatous Polyps in the Duodenum

Adenomatous Polyps in the DuodenumAdenomatous Polyps in the Duodenum

Duodenal Carcinoid Tumor

Duodenal Carcinoid TumorDuodenal Carcinoid Tumor

Duodenal Carcinoid Tumor

Duodenal Carcinoid TumorDuodenal Carcinoid Tumor

 

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