Case report: Severe adverse reaction to oral Iohexol

Glover, Jennifer; Thomas, B.M.

doi:10.1016/s0009-9260(05)80518-5

Cited by 13 publications

(7 citation statements)

References 9 publications

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“…We also encountered an anaphylactic-type reaction to oral iohexol in a 31-year-old man. These reactions are extremely rare, this patient forming the basis of a previous case report [3].…”

Section: Discussionmentioning

confidence: 61%

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The use of non-ionic water-soluble contrast agents for small bowel follow-through examination

1999

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In certain situations it is preferable to perform small bowel examination using water-soluble contrast agents. Generally, ionic agents are used, but non-ionic agents may be an alternative in certain circumstances. We retrospectively reviewed a consecutive series of small bowel examinations using non-ionic media in order to determine their efficacy. A total of 52 water-soluble non-ionic small bowel follow-through examinations were performed in 42 patients using 100 ml iohexol. Indications for the study and the reasons why barium sulphate suspensions were contraindicated were established. Studies were assessed for radiographic quality and clinical findings were noted, and comparison was made with operative findings and clinical outcome. Obstruction was diagnosed in 12 examinations and the radiological findings were confirmed in all 7 patients surgically treated. Fistulae were identified in 11 examinations and the radiological findings were confirmed in all 8 patients who were treated by laparotomy. Additionally, at laparotomy no obstruction or fistula was found in the 5 patients in whom prior contrast examination had been negative. Non-ionic water-soluble follow-through examination is easily performed and well tolerated, allowing accurate diagnosis of obstruction and fistula when barium suspensions are contraindicated.

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“…We also encountered an anaphylactic-type reaction to oral iohexol in a 31-year-old man. These reactions are extremely rare, this patient forming the basis of a previous case report [3].…”

Section: Discussionmentioning

confidence: 61%

“…The procedure was well tolerated by the majority of patients. One patient had a major anaphylactic reaction to iohexol [3]. It was possible to examine the entire small bowel in the 21 patients (26 examinations) without previous small bowel resection.…”

Section: Resultsmentioning

confidence: 99%

The use of non-ionic water-soluble contrast agents for small bowel follow-through examination

1999

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“…Gastrografin is rapidly diffused within the peritoneal cavity following extraluminal leakage [19]. It is then reabsorbed and excreted promptly by the urinary tract [20]. Accordingly, CM in the urinary tract on an unenhanced CT scan can indirectly confirm a suspected perforation.…”

Section: Discussionmentioning

confidence: 99%

“…This radiological finding has proved to be a significant indicator that differentiates those patients with bowel diseases from those without it. This phenomenon has added clinical significance because the risk of allergic reaction to orally ingested gastrografin is greatly enhanced when increased permeability or perforation of the GIT is present [20][21][22]. …”

Section: Discussionmentioning

confidence: 99%

Urinary excretion of orally ingested gastrografin on CT

et al. 1998

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Renal excretion of orally ingested gastrografin has rarely been reported on computed tomography (CT). We studied the unenhanced scans of 82 patients with bowel disorders or perforation to assess the prevalence of urinary contrast material (CM) in various bowel diseases. We also assessed the clinical significance of this sign. In addition, we reviewed the unenhanced CT scans of 100 randomly selected patients without bowel diseases as a control group. Twenty-nine of the 58 patients with bowel diseases, six of nine with free perforation, and one of 15 with covered perforation had CM in the urinary tract. None of the 100 without bowel disease showed urinary CM. Statistical analysis was done by using the Fisher's exact test. The prevalence of urinary CM was highest in inflammatory bowel disease, radiation enteritis, and free perforation (p < 0. 0001). This study shows that the CT finding of orally ingested gastrografin in the urinary tract differentiates patients with bowel disease from those without.

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“…Another important function is the conversion of ethanol to acetaldehyde and acetate, bypassing the main metabolic pathway of alcohol dehydrogenase by the so called 'microsomal ethanol oxidizing system (MEOS)' [3]. Interindividual variability of CYP2E1 activity is considerable and influenced by a number of intrinsic (bodyweight, gender, race) and extrinsic factors (co-medication, alcohol consumption) [4]. As an example, co-administration of disulfiram inhibits CYP2E1 [5] leading to a protracted elimination of CYP2E1 substrates such as sevoflurane [6].…”

Section: Introductionmentioning

confidence: 99%