An international survey to assess use of oral and rectal contrast in CT protocols for penetrating torso trauma.
Emerg Radiol. 2019 Apr;26(2):117-121. doi: 10.1007/s10140-018-1650-7. Epub 2018 Oct 21.
Ozimok CJ1, Mellnick VM2, Patlas MN3.
PURPOSE: There is controversy regarding the administration of oral and rectal contrast for CT performed to detect bowel injury in the context of penetrating torso trauma. Given the lack of published societal guidelines, our goal was to survey radiologists from the American Society of Emergency Radiology membership database to determine consensus on CT protocols for penetrating trauma.
METHODS: With ethics board approval, an anonymous ten-question online survey was distributed via email to 589 radiologists in the American Society of Emergency Radiology (ASER) member database. The survey was open for a 4-week period in February 2018. A commercially available website that allows subscribers to create and analyze survey results was used for analysis.
RESULTS: We received 124 responses (21% response rate) with a majority from U.S. institutions (82%). Seventy-four percent of respondents indicated they do not routinely administer oral contrast in penetrating trauma, 68% do not administer rectal contrast, and 90% do not use commercially available software to assess penetrating injury trajectory. Results from U.S. and non-U.S. practices were comparable. The decision to administer intraluminal contrast is made by the referring physician at 52% of institutions. There is in-house attending level radiology coverage at 54% of institutions and when asked if trauma scans are reviewed before removing the patient from the table, 41% of respondents answered "No."
CONCLUSION: Enteric contrast is used in a minority of respondents' centers for penetrating trauma cases, which is likely driven by a perceived lack of added benefit and delays in patient care.