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Oral Contrast Agents for CT of Abdominal Trauma in Pediatric Patients: A Comparison of Dilute Hypaque and Water

Mark J. Halsted1,2, John M. Racadio1,2, Kathleen H. Emery1,2, Peter Kreymerman3, Stacy A. Poe4, Judy A. Bean4 and Lane F. Donnelly1,2

1 Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229-3039.
2 Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039.
3 Department of Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195.
4 Center for Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039.



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  		Fig. 1A. —CT scans of stomach wall obtained in two patients who sustained blunt abdominal trauma. Water appears to be superior to dilute Hypaque Sodium ([diatrizoic acid dihydrate] Amersham Health) for visualization of stomach wall in this child, although no statistically significant overall difference was found between these agents. 16-year-old boy with splenic rupture and perisplenic hematoma who received water as oral contrast agent. Stomach wall is well depicted when outlined internally by low-attentuation water and externally by low-attenuation mesenteric fat.

 


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  		Fig. 1B. —CT scans of stomach wall obtained in two patients who sustained blunt abdominal trauma. Water appears to be superior to dilute Hypaque Sodium ([diatrizoic acid dihydrate] Amersham Health) for visualization of stomach wall in this child, although no statistically significant overall difference was found between these agents. 15-year-old boy who received dilute Hypaque Sodium ([diatrizoic acid dihydrate] Amersham Health). Definition of inner edge of stomach wall is not as clear as in A with more highly attenuated dilute Hypaque in gastric lumen.

 


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  		Fig. 2. —CT scan obtained with water as oral contrast material in 13-year-old boy who sustained blunt abdominal trauma shows that wall of duodenum is sharply delineated because of presence of water within its lumen and mesenteric fat surrounding its periphery.

 


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  		Fig. 3. —On CT scan obtained in 2-year-old boy who sustained blunt abdominal trauma, streak artifact caused by presence of dilute Hypaque Sodium ([diatrizoic acid dihydrate] Amersham Health) in stomach lumen extends across anterior aspect of liver.

 

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