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Comparison of Colonic Transit Between Polyethylene Glycol and Water as Oral Contrast Vehicles in the CT Evaluation of Acute Appendicitis

Jeffrey J. Hebert1,2, Andrew J. Taylor1 and Thomas C. Winter1

1 Department of Radiology, University of Wisconsin, 600 Highland Ave., Madison, WI 53792-3252.
2 Present address: X-Ray Associates of New Mexico, Albuquerque, NM 87110.


Figure 1
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  		Fig. 1A —32-year-old woman with abdominal pain. CT images obtained with IV and polyethylene glycol-based oral contrast agents for evaluation of appendicitis. Cecum (c, A) and appendix (arrow, B) are filled with oral contrast material, confirming absence of appendicitis in this patient. Appendix extends posterior toward uterus (u, B).

 

Figure 2
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  		Fig. 1B —32-year-old woman with abdominal pain. CT images obtained with IV and polyethylene glycol-based oral contrast agents for evaluation of appendicitis. Cecum (c, A) and appendix (arrow, B) are filled with oral contrast material, confirming absence of appendicitis in this patient. Appendix extends posterior toward uterus (u, B).

 

Figure 3
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  		Fig. 2 —40-year-old woman with appendicitis. Coronal reformatted image from CT performed with IV contrast agent and polyethylene glycol-based oral contrast agent shows cecum (C) filled with oral contrast material. Obstructing appendicolith (arrow) can easily be identified with associated dilatation and inflammation of appendix.

 

Figure 4
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  		Fig. 3 —67-year-old man with diverticulitis. CT image obtained using IV contrast agent and polyethylene glycol-based oral contrast agent for evaluation of abdominal pain shows findings suggestive of diverticulitis (arrow) in descending colon. Oral contrast material is identified traversing to level of left colon even in setting of inflammatory process.

 

Figure 5
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  		Fig. 4 —45-year-old man with appendicitis. Coronal reformatted image from CT performed with IV contrast agent and polyethylene glycol-based oral contrast agent shows appendicolith (arrow) with associated periappendiceal abscess (a) that results in small-bowel obstruction. Oral contrast material does not reach cecum in this patient.

 

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