Purpose
To assess the waiting time prior to patient undergoing abdominopelvic CT under various circumstances.To assess patient compliance in the various groups.To detect the common problems faced by the patient and ways to rectify them.We compared the demographics of these groups having the chance of anaphylactoid reactions with those having nonanaphylactoid and none.
Study/Project design
Total 2400 cases with different oral contrast preparation were included. Contrast agents and patients were chosen in a randomized order.Their ages ranged from 20 to 80 years (mean, 54.6 years); 49% patients were scanned as outpatients, 26% as inpatients, and 24% in the emergency department. All CT scans were performed with IV iopromide (Ultravist) at a dose of 75–100 mL of 300 mg I/mL or 125–150 mL of 370 mg I/mL. The higher dose was used only for patients who underwent CT angiography (including scans...
Results
Descriptive analyses of the variables, comparisons of means, and proportions using Student's t and chisquare tests, and logistic regressions were conducted.Patients who experienced adverse events and patients who did not were compared to evaluate differences in age, sex, dose of contrast agent (in grams of iodine), patient's status during study (i.e., inpatient vs outpatient vs emergency department patient), and time of study (i.e., month and season). Adverse events were observed in 111 patients (14.4%) and were categorized as follows: urticaria (n = 87), facial or...
Discussion
ETIOLOGY OF CONTRAST REACTIONSThere are 2 basic types of contrast reactions; the first is the anaphylactoid or idiosyncratic, and the second is the nonanaphylactoid. Contrast reactions may occur from either one or a combination of both of these effects. Anaphylactoid/Idiosyncratic ReactionsAs the name suggests, the exact etiology for these reactions is less well understood, and they tend to mimic an anaphylactic (allergic) reaction. The proposed mechanism of these reactions includes enzyme induction, causing the release of vasoactive substances such as histamine and serotonin and the...
Conclusions
Waiting time prior to abdominopelvic does affect the patient.Appropriate decision making helps in decreasing the waiting time and getting the best of the imaging.Clinical assessment of the patient and indication for the CT should be kept under consideration before planning the preprocedure preparation.Flexibility of the radiologist and proper patient assessment not only increase the patient compliance , it also increased the diagnostic yield.Iodinated contrast media are frequently used and are safe. Reactions, when they occur, are usually mild but may occasionally progress to life-threatening proportions....
References
Seymour CW, Pryor JP, Gupta R, Schwab CW. Anaphylactoid reaction to oral contrast for computed tomography. J Trauma. 2004;57:1105–1107. Miller SH. Anaphylactoid reaction after oral administration of diatrizoate meglumine and diatrizoate sodium solution. AJR. 1997;168:959–961. Wolf GL, Mishkin MM, Roux SG, et al. Comparison of the rates of adverse drug reactions: ionic contrast agents, ionic agents combined with steroids, and nonionic agents. Invest Radiol. 1991;26:404–410. Armen RN, Cohen SG, Kantor M. Anaphylactoid reaction following the oral administration of iodide-containing cholecystographic media. J Allergy. 1956;27:544–547.
Personal Information
Author details:Dr. Abhishek Mahajan, MBBS,MDFellow in Cancer ImagingDept of Radiodiagnosis & ImagingTata Memorial HospitalDr E Borges RoadParelMumbaiMaharashtra400 012India(+919920354764)
[email protected]