Oral CT Contrast

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Our majority of major injuries are blunt. Main difficulty is excluding bowel inj. esp. when it is difficult to get physical signs.
  Q 1.Do your CT can detect bowel wall defects without contrast?
  2. Do you use rectal contrast?
  3.What harm does oral contrast do apart from delay?
  Thanks 
  Ranjith
  Sri lanka

cathy armstrong <cathyarmstrong1 at googlemail.com> wrote:
  On 7/10/08, Timothy Craig Hardcastle wrote:
>
> Ken
>
> Two comments:
> 1: It depends on the quality of your scanner.
> 2: It depends what you are suspecting.
>
> The CT is notorious for being equivocal in identifying the early blunt
> duodenal leak - here a rescan with a minimal amount of contrast MAY be
> useful. The other area is when there is a risk of so-called partial
> voluming at the D3 / neck of pancreas junction and a pancreas injury is
> suspected. To avoid the VOMIT and better delineate the lumen of the D3
> contrast may be useful.
>
> For the rest - I agree: No, no and HELL NO!
>
> Tim
> Dr Timothy C Hardcastle
> M.B., Ch.B. (Stell); M. Med (Chir) (Stell); FCS (SA)
> Principal Surgeon-Lecturer / Sub-specialist: Trauma and Critical Care
> Deputy director: Trauma Unit and Trauma ICU
> Inkosi Albert Luthuli Central Hospital / UKZN
> 800 Bellair Road
> Mayville, Durban
>
> Postal: PostNet Suite 27
> Private Bag X05
> Malvern, 4055
> KwaZulu Natal
>
> timothyhar at ialch.co.za
>
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org] On Behalf Of KMATTOX at aol.com
> Sent: 10 July 2008 04:16
> To: trauma-list at trauma.org
> Subject: Re: Oral CT Contrast
>
> No, NO, HELL NO. We stopped doing that about 6 years ago. Numerous
>
> papers have demonstrated that such adds risks and does not provide ANY
> new useful
> information that alters decision making, diagnosis, or outcome. I
> thought the entire world of patient care had stopped this historic
> urban legend.
>
> k
>
>
> In a message dated 7/9/2008 10:18:14 A.M. Central Daylight Time,
> dburgess at mhg.com writes:
>
> Do you give oral (or NG) contrast for trauma abdominal CTs? Any
> suggested
> references?
>
>
>
>
>
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