Gastrointestinal
Water loading: give 5 cups (about 800 ml) during the 15 minutes before getting on the CT scanner table. 3 of these cups should be given outside awaiting the scan and 2 cups of water in the scanner room. Do not give the water too early.
Priority Description
1. P1 High probability of potentially life threatening condition
2. P2 High probability of condition potentially causing significant long term harm
3. P3 Possibility of potentially life threatening condition
4. P4 Possibility of condition potentially causing significant long term harm
5. P5 Unlikely to be life threatening or cause significant long term harm
| Protocol code | When to use |
|---|---|
| ?Ca 2Wk | ? Cancer 2ww – use as normal – scan to be scheduled within 2 weeks |
| Urgent | Urgent – use as normal – scan to be scheduled within 4 weeks |
| COVID – Semi Urgent | Examination needs performing during next few months |
| Routine | Do not use during Covid pandemic |
| COVID P5 Cancel | Examination is P5 exam and will be cancelled and re refer back to clinician |
| Cancel | Examination to be cancelled due to non-justification of examination only ( not due to COVID) |
| On hold | Use as normal |
All routine are reclassified as above.
| Indication | COVID Cancel | COVID Urgent/Priority Category | Brief description | Slice thickness and reconstruction kernel | Further details of contrast timing/explanation of what the radiographers do | Abbreviation |
|---|---|---|---|---|---|---|
|
Cancer of oesophagus, stomach, duodenum, gallbladder, pancreas and colon/rectum |
X |
CT chest, abdomen & pelvis (contrast) |
1.5 mm B30f, 1.2 mm increment. |
65 seconds post contrast + oral water as above |
CT CAP + c + oral water
| |
|
Anal cancer |
X |
CT abdomen & pelvis (contrast) |
1.5 mm B30f, 1.2 mm increment. |
65 seconds post contrast |
CT abdomen and pelvis + c
| |
|
Colorectal Ca? Including if failed or refused colonoscopy |
X |
CT colonography |
1.5 mm B30f, 1.2 mm increment. |
See specific guidance |
CT colonography
| |
|
Active GI bleeding |
X |
Pre/arterial/delayed abdomen and pelvis |
1.5 mm B30f, 1.2 mm increment. |
Pre, arterial and 90 sec bolus tracked as described below |
CT angio triple phase abdomen (90 second) | |
|
Mesenteric ischaemia |
X |
Pre/arterial/PV abdomen and pelvis |
1.5 mm B30f, 1.2 mm increment. |
Pre, arterial and 65 sec bolus tracked as described below |
CT angio triple phase abdomen (65 second) | |
|
Acute abdominal pain (diverticulitis, appendicitis, perforation, obstruction, GB perforation, abdominal or pelvic collection, etc) |
X |
PV abdomen and pelvis |
1.5 mm B30f, 1.2 mm increment. |
65 seconds |
CT abdomen and pelvis + c
| |
|
Neuroendocrine tumour including carcinoid |
X |
CT Chest, abdomen and pelvis + arterial phase abdomen |
1.5 mm B30f, 1.2 mm increment. |
Arterial abdo + CAP in PV phase
| ||
|
Anastamotic leak |
X |
CT abdomen and pelvis with i.v. and oral contrast |
1.5 mm B30f, 1.2 mm increment. |
DEPRECATED SEE ROWS BELOW
|
CT abdomen and pelvis + i.v. + oral contrast | |
|
Oesophageal perforation |
X |
CT thorax with i.v. and oral contrast |
1.5 mm B30f, 1.2 mm increment. |
65 seconds + 100 ml 4-6% water soluble contrast slowly over 3-5 minutes before scan |
CT thorax/oesophagus with i.v. and oral contrast (100 ml 4-6% water soluble contrast slowly over 3-5 minutes before scan) | |
|
Oesophageal surgery (e.g. Ivo Lewis) |
X |
CT thorax and abdomen with i.v. and oral contrast |
1.5 mm B30f, 1.2 mm increment. |
65 seconds + 200 ml 4-6% water soluble contrast slowly over 5-10 minutes before scan |
CT thorax/oesophagus with i.v. and oral contrast (200 ml 4-6% water soluble contrast slowly over 5-10 minutes before scan) | |
|
Gastric surgery (e.g. gastrectomy) |
X |
CT abdomen and pelvis with i.v. and oral contrast |
1.5 mm B30f, 1.2 mm increment. |
65 seconds + 300 ml 4-6% water soluble contrast slowly over 15 minutes before scan |
CT abdomen and pelvis with i.v. and oral contrast (300 ml water soluble contrast slowly over 15 minutes before scan) | |
|
Small bowel with oral contrast |
X |
CT abdomen and pelvis with i.v. and oral contrast |
1.5 mm B30f, 1.2 mm increment. |
65 seconds + 500 ml 4-6% water soluble contrast slowly over 30-60 minutes before scan |
CT abdomen and pelvis with i.v. and oral contrast (500 ml water soluble contrast slowly over 30-60 minutes before scan) | |
|
Leak from roux-en-Y gastrectomy |
X |
CT abdomen and pelvis with i.v. and oral contrast |
1.5 mm B30f, 1.2 mm increment. |
65 seconds + 300 ml 4-6% water soluble contrast slowly over 30-60 minutes before scan then 100 ml slowly over 10 minutes before scan |
CT abdomen and pelvis with i.v. and oral contrast (300 ml water soluble contrast slowly over 30-60 minutes before scan then 100 ml slowly over 10 minutes before scan) | |
|
Scans requiring rectal contrast |
CT abdomen and pelvis with i.v. and rectal contrast |
1.5 mm B30f, 1.2 mm increment. |
65 seconds + 100 ml 4-6% water soluble contrast rectally before scan |
CT abdomen and pelvis with i.v. and rectal contrast (100 ml 4-6% water soluble contrast rectally before scan) | ||
|
Superior mesenteric artery (SMA) syndrome |
CT abdomen & pelvis in arterial phase/angio |
1.5 mm B30f, 1.2 mm increment. |
CT angio abdomen or abdomen and pelvis (if more clinical questions) |
CT angiogram abdomen and pelvis |