ORAL CONTRAST IS NOT NECESSARY IN THE EVALUATION OF BLUNT ABDOMINAL-TRAUMA BY COMPUTED-TOMOGRAPHY

The administration of oral contrast (OC) is widely recommended for com puted tomography (CT) of the abdomen in patients with blunt trauma. Th e purpose of this study was to determine whether routine abdominal CT scans performed without OC were associated with diagnostic error in pa tients with blunt trauma. Four hundred ninety-two patients were identi fied from our Trauma Registry who had CT scans for the evaluation of b lunt abdominal trauma between January 1988 and December 1991. Seventy- six percent (372) of the CT scans were interpreted as negative, and 24 % (120) were considered positive. OC was used in 8 (1.6%) of 492 patie nts. Only 1 of 372 patients whose initial non-OC-enhanced scan was neg ative subsequently required surgery. There were 5 bowel injuries among the 42 patients who underwent an abdominal operation; in none would t he use of OC have ensured the preoperative diagnosis. We found that th e omission of OC did not represent a disadvantage to patients with blu nt trauma undergoing a routine abdominal CT scan. Potential time delay s and the hazards associated with the use of OC were minimized.