CT contrast media extravasation

Background

complication of contrast-enhanced CT scanning
- may also occur from MRI, but rare given low volume used

Epidemiology

~0.5% (range 0.13-0.68%) of cases

Clinical Features

Swelling and/or blistering at injection site

Differential Diagnosis

Contrast induced complications

Contrast induced allergic reaction
Contrast-induced nephropathy
CT contrast media extravasation
Nephrogenic Systemic Fibrosis - gadolinium in GFRs < 60

Evaluation

Clinical (if no complication)

Management

Stop infusion immediately
Remove IV canula
Ice pack to affected area
Elevate

Complications

97% have minimal or no injury
- 79% have localized swelling after extravasation
- 24% had pain
- 8%
Large volumes (> 50 mL) of high-osmolar contrast media = highest risk
- skin ulceration
- soft-tissue necrosis
- compartment syndrome

Disposition

May discharge after 2 hours with precautions if no signs of complications

See Also

Iatrogenic intra-arterial injection

External Links

References

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