European Radiology

, Volume 23, Issue 9, pp 2513–2521

Use of positive oral contrast agents in abdominopelvic computed tomography for blunt abdominal injury: meta-analysis and systematic review

  • Chau Hung Lee
  • Benjamin Haaland
  • Arul Earnest
  • Cher Heng Tan



To determine whether positive oral contrast agents improve accuracy of abdominopelvic CT compared with no, neutral or negative oral contrast agent.


Literature was searched for studies evaluating the diagnostic performance of abdominopelvic CT with positive oral contrast agents against imaging with no, neutral or negative oral contrast agent. Meta-analysis reviewed studies correlating CT findings of blunt abdominal injury with positive and without oral contrast agents against surgical, autopsy or clinical outcome allowing derivation of pooled sensitivity and specificity. Systematic review was performed on studies with common design and reference standard.


Thirty-two studies were divided into two groups. Group 1 comprised 15 studies comparing CT with positive and without oral contrast agents. Meta-analysis of five studies from group 1 provided no difference in sensitivity or specificity between CT with positive or without oral contrast agents. Group 2 comprised 17 studies comparing CT with positive and neutral or negative oral contrast agents. Systematic review of 12 studies from group 2 indicated that neutral or negative oral contrasts were as effective as positive oral contrast agents for bowel visualisation.


There is no difference in accuracy between CT performed with positive oral contrast agents or with no, neutral or negative oral contrast agent.

Key Points

There is no difference in the accuracy of CT with or without oral contrast agent.

There is no difference in the accuracy of CT with Gastrografin or water.

Omission of oral contrast, utilising neutral or negative oral contrast agent saves time, costs and decreases risk of aspiration.


Abdomen Computed tomography Oral Contrast agent Meta-analysis 


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Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Chau Hung Lee
    • 1
  • Benjamin Haaland
    • 2
  • Arul Earnest
    • 3
  • Cher Heng Tan
    • 1
  1. 1.Department of RadiologyTan Tock Seng HospitalSingaporeSingapore
  2. 2.Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Graduate Medical School; Department of Statistics and Applied ProbabilityNational University of SingaporeSingaporeSingapore
  3. 3.Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Graduate Medical School, SingaporeSingaporeSingapore

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