Oral contrast omission in the computed tomographic evaluation of blunt abdominal trauma: a literature review

The purpose of this review is to examine existing research on oral contrast administrating as it pertains to the computed tomographic (CT) evaluation of blunt abdominal trauma, as well as to determine the necessity of oral contrast as part of a CT scanning universal protocol. Many hospitals routinely administer both oral and intravenous contrast prior to abdominal CT scan. There have been found to be numerous disadvantages and risks associated with oral contrast administration prior to CT scan. There has been a shift in many hospitals over the years from traditional CT scanners to multidetector row helical scanners, which allow for thinner collimation and higher spatial resolution. With the advances in technology, from single detector row to multidetector row helical CT scanners, the question whether oral contrast is necessary, useful, or dangerous presents itself. There is a significant lack of research on this topic over the past 10 years. All of the studies referenced support no longer administering oral contrast for the initial evaluation of the patient with blunt abdominal trauma. However, the findings of the studies cited in this article are based on small sample sizes and low incidences of solid organ, bowel, or mesenteric injuries. The current level of available research has significant limitations to support a recommendation to eliminate the administration of oral contrast before obtaining the initial CT scanning for blunt abdominal trauma. Further research is necessary before any conclusion or practice change can be made.