no contrast for abdominal CT?

10 Mar

yet another ACEP excerpt from Jan’s EMed Journal:

HIGHLIGHTS:

“Oral contrast rarely needed before CT scan of adults with acute abdomen.”

non-contrast CT for appendicitis:

  • sensitivity 93%
  • specificity 96%

‘”You only [lose] about 2 percentage points” on diagnostic accuracy by forgoing contrast, and the difference in one study “was not statistically significant.”‘

…'”if you’re thinking about mesenteric ischemia, thrombosis, abdominal aortic aneurysm” or some other vascular cause of abdominal pain, “you want to consider giving IV contrast”‘

Nice thing to remind ourselves about now & again.

References: emed journal; non-con CT study; diagnostic accuracy study; picture

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