ASPIRATION AFTER ADMINISTRATION OF ORAL CONTRAST MATERIAL IN CHILDRENUNDERGOING ABDOMINAL CT FOR TRAUMA

OBJECTIVE. The practice of routinely administering oral contrast mater ial to children undergoing abdominal CT for blunt trauma is controvers ial, primarily because of the increased risk of aspiration. The purpos e of this study was to determine how often aspiration occurs in this p opulation of children. MATERIALS AND METHODS, We retrospectively studi ed 50 children who underwent abdominal CT scans after blunt trauma. Al l children received diluted 3% water-soluble oral contrast material. T he medical record of each child was reviewed for evidence of aspiratio n pneumonia as many as 48 hr after the CT. In each patient, sections o f the CT scan through the lung bases were examined for opacities. When lung opacities were identified, they were classified as atelectasis, contusion, laceration, or nonspecific. We made attenuation measurement s of lung opacities larger than 1 cm, and each measurement was compare d with the attenuation measurement of contrast material in that patien t's stomach. Student's two-tailed t test was used to compare the two m easurements. RESULTS, Four patients were febrile after the CT scan, bu t in none was aspiration pneumonia suspected to be the cause. The rema ining 46 patients did not have any clinical evidence of aspiration, Tw elve of the 50 patients had pulmonary opacities revealed by CT that we re sufficiently large that attenuation measurements could be obtained. The opacity in one of these patients was classified as nonspecific, a nd the attenuation was as high as that of contrast material in the sto mach. CONCLUSION. No clinically symptomatic episodes of aspiration pne umonia were found in 50 pediatric patients with blunt trauma who were given oral contrast material for abdominal CT, Although one of the chi ldren had CT findings that suggested clinically silent aspiration of o ral contrast material, no evidence was found that administration of or al contrast material was harmful.