YDR Oral Contrast Policy for Abdominal CT in ED Patients

Oral Contrast is only* required for:

1. Very thin Patients for abdominal pain.
2. Post-op bowel surgery, fistula or Crohn's Disease
3. When IV contrast is contraindicated
4. Pediatric Patients

*at discretion of attending radiologist

• CT A/P without contrast:
  Cases ordered as CT kidney stone exam
• CT A/P with IV only:
  Patients with RLQ pain and lower abdominal pain, if BMI >25
• CT A/P with IV only regardless of BMI:
  Diffuse abdominal pain, Trauma, Lower GI bleed, Bowel obstruction (abdominal distention, vomitting, dilated loops in plain radiograph), AAA, suspected bowel ischemia
• CT A/P with IV and oral contrast:
  Suspected fistula, post-op bowel surgery, hx. of Crohn's Diaease
• CT A/P with oral only:
  Contraindication for IV, regardless of BMI or indication (except renal stone)
• In special cases, contrast administration can still be prescribed at the discretion of the ED radiologist.