Article Figures & Data
Figures
- Figure 1
Computed tomography with intravenous contrast enhancement in a patient with right-lower-quadrant abdominal pain. Axial (A) and coronal (B) views reveal diffuse mural and periappendiceal edema, with thickening of the appendix (red arrows). Coarse calcification within the appendix (yellow arrow) likely represents an appendicolith.
- Figure 2
Computed tomography with a neutral oral contrast agent. Axial (A) and coronal (B) views reveal multiple loops of dilated bowel (red arrows) with a transition point—ie, site of sudden luminal narrowing (yellow arrows)—in the left lower quadrant, findings consistent with a small-bowel obstruction.
Tables
Intravenous contrast required Gastrointestinal conditions Acute abdominal pain Abdominal trauma Abdominal mass Abdominal infection Gastrointestinal bleeding (if endoscopy is negative, use computed tomography angiography) Pancreatitis Liver cancer Cirrhosis Portal vein thrombosis Biliary obstruction Inflammatory bowel disease Small-bowel obstruction Appendicitis Diverticulitis Colitis Urinary tract conditions Renal trauma Pyelonephritis Adrenal mass, cancer Renal mass, cancer Bladder mass, cancer Vascular conditions (CT angiography required) Aortic dissection Abdominal aortic aneurysm Renovascular hypertension Intravenous contrast not required Hematoma Bowel perforation/free air Nephrolithiasis Colon cancer screening (CT colonography) Based on information in reference 3.
Elective (12- or 13-hour) regimen Oral regimens Prednisone 50 mg at 13 hours, 7 hours, and 1 hour before contrast administration, with or without diphenhydraminea 50 mg 1 hour before contrast administration Methylprednisolone 32 mg at 12 and 2 hours before contrast administration, with or without diphenhydraminea 50 mg 1 hour before contrast Intravenous regimen (for patients unable to take medications by mouth) Hydrocortisone 200 mg at 13 hours, 7 hours, and 1 hour before contrast administration, with or without diphenhydraminea 50 mg 1 hour before contrast administration Emergency regimen Methylprednisolone 40 mg or hydrocortisone 200 mg immediately, then every 4 hours until contrast administration, with or without diphenhydraminea 50 mg 1 hour before contrast administration ↵a The addition of diphenhydramine is optional. Evidence on its value is mixed.
Based on information in reference 8.
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