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Trade names | Hypaque, Gastrografin, Iothalmate, others |
Other names | amidotrizoic acid, diatrizoic acid, 3,5-diacetamido-2,4,6-triiodobenzoic acid |
AHFS/Drugs.com | Micromedex Detailed Consumer Information |
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CompTox Dashboard (EPA) | |
ECHA InfoCard | 100.003.840 |
Chemical and physical data | |
Formula | C11H9I3N2O4 |
Molar mass | 613.916 g·mol−1 |
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Diatrizoate, also known as amidotrizoate, Gastrografin, is a contrast agent used during X-ray imaging. [1] This includes visualizing veins, the urinary system, spleen, and joints, as well as computer tomography (CT scan). [1] It is given by mouth, injection into a vein, injection into the bladder, through a nasogastric tube, or rectally. [2] [3]
Relatively common side effects include vomiting, diarrhea, and skin redness. [4] Other side effects include itchiness, kidney problems, low blood pressure, and allergic reactions. [1] It is not recommended in people who have an iodine allergy. [1] Diatrizoate is an iodinated ionic radiocontrast agent with high osmolality. [2]
Diatrizoate was approved for medical use in the United States in 1954. [4] It is on the World Health Organization's List of Essential Medicines. [5]
This section may be confusing or unclear to readers.(June 2019) |
Diatrizoic acid may be used as an alternative to barium sulfate for medical imaging of the gastrointestinal tract, such as upper gastrointestinal series and small bowel series. It is indicated for use in patients who are allergic to barium, or in cases where the barium might leak into the abdominal cavity. It does not coat the stomach/bowel lining as well as barium, so it is not used commonly for this purpose.[ citation needed ]
It is also used to treat Ascaris lumbricoides (roundworms). [6] [7] Diatrizoate may not actually kill Ascaris, but instead it promotes shifting of fluid in the bowel lumen due to its osmotic properties[ clarify ], so may relieve intestinal obstruction caused by impacted Ascaris. [8]
Diatrizoate is used in suspected intestinal perforation, meconium ileus, and to identify bowel-lumen communication. It should not be used to investigate tracheo-oesophageal fistula because it can cause pulmonary oedema when aspirated into respiratory system. Diatrizoate can dislodge sticky meconium by drawing water into intestines. [9] Diatrizoate is minimally absorbed from the intestines and excreted into urinary bladder. [10] Because of its high osmolarity it can draw water from the surrounding tissues into the intestines, thus cause dehydration in people with already small plasma volume such as infants. Because of the additives and flavouring agents, diatrizoate formulated as Gastrografin must not be used intravascularly, though other formulations of diatrizoate are indicated for intravascular use. This chemical must be keep away from sunlight during storage. [11]
It is given orally on computed tomography of the abdomen and pelvis as 30 ml solution with 3% concentration to visualise the bowel lumen and any communications with the bowel lumen. [12] In principle, diatrizoic acid is administered by the route most appropriate and sensible to image the structure/-s of interest (e.g., IV for blood vessels through which it is distributed and kidney–ureters–bladder that excrete it; orally or per rectally as an enema for the gastrointestinal tract).[ citation needed ]
A history of sensitivity to iodine is not a contraindication to using diatrizoate, although it suggests caution in use of the agent. In this case, a regimen of oral or intravenous corticosteroids may be given as prophylaxis, or an alternative such as barium sulfate may be preferable.[ citation needed ]
Gastrografin is contraindicated to use along with certain medications that can cause lactic acidosis, such as metformin. Concurrent use may lead to kidney failure and lactic acidosis, and a clinician may need to space the agents apart over a number of days to prevent an interaction. [13]
Gastrografin is a hypertonic solution, and therefore it should be avoided in imaging studies of the upper gastrointestinal tract in patients who are at risk of aspiration, as it will cause prompt pulmonary edema if accidentally introduced into the tracheobronchial tree.[ citation needed ]
Urografin is not to be used for myelography, ventriculography or cisternography, since it is likely to provoke neurotoxic symptoms in these examinations. [14]
Diatrizoate is considered a high-osmolality contrast agent. Its osmolality ranges from approximately 1500 mOsm/kg (50% solution) [15] to over 2000 mOsm/kg (76% solution). [16]
Brand names include Hypaque, Gastrografin, MD-Gastroview, Iothalmate, and Urografin. Urografin is a combination of the sodium and meglumine salts.[ citation needed ]
The gastrointestinal tract is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and other animals, including the esophagus, stomach, and intestines. Food taken in through the mouth is digested to extract nutrients and absorb energy, and the waste expelled at the anus as faeces. Gastrointestinal is an adjective meaning of or pertaining to the stomach and intestines.
A lower gastrointestinal series is a medical procedure used to examine and diagnose problems with the human colon of the large intestine. Radiographs are taken while barium sulfate, a radiocontrast agent, fills the colon via an enema through the rectum.
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. GISTs arise in the smooth muscle pacemaker interstitial cell of Cajal, or similar cells. They are defined as tumors whose behavior is driven by mutations in the KIT gene (85%), PDGFRA gene (10%), or BRAF kinase (rare). 95% of GISTs stain positively for KIT (CD117). Most (66%) occur in the stomach and gastric GISTs have a lower malignant potential than tumors found elsewhere in the GI tract.
An upper gastrointestinal series, also called a barium swallow, barium study, or barium meal, is a series of radiographs used to examine the gastrointestinal tract for abnormalities. A contrast medium, usually a radiocontrast agent such as barium sulfate mixed with water, is ingested or instilled into the gastrointestinal tract, and X-rays are used to create radiographs of the regions of interest. The barium enhances the visibility of the relevant parts of the gastrointestinal tract by coating the inside wall of the tract and appearing white on the film. This in combination with other plain radiographs allows for the imaging of parts of the upper gastrointestinal tract such as the pharynx, larynx, esophagus, stomach, and small intestine such that the inside wall lining, size, shape, contour, and patency are visible to the examiner. With fluoroscopy, it is also possible to visualize the functional movement of examined organs such as swallowing, peristalsis, or sphincter closure. Depending on the organs to be examined, barium radiographs can be classified into "barium swallow", "barium meal", "barium follow-through", and "enteroclysis". To further enhance the quality of images, air or gas is sometimes introduced into the gastrointestinal tract in addition to barium, and this procedure is called double-contrast imaging. In this case the gas is referred to as the negative contrast medium. Traditionally the images produced with barium contrast are made with plain-film radiography, but computed tomography is also used in combination with barium contrast, in which case the procedure is called "CT enterography".
Radiocontrast agents are substances used to enhance the visibility of internal structures in X-ray-based imaging techniques such as computed tomography, projectional radiography, and fluoroscopy. Radiocontrast agents are typically iodine, or more rarely barium sulfate. The contrast agents absorb external X-rays, resulting in decreased exposure on the X-ray detector. This is different from radiopharmaceuticals used in nuclear medicine which emit radiation.
In medicine or biology, a diverticulum is an outpouching of a hollow structure in the body. Depending upon which layers of the structure are involved, diverticula are described as being either true or false.
Dumping syndrome occurs when food, especially sugar, moves too quickly from the stomach to the duodenum—the first part of the small intestine—in the upper gastrointestinal (GI) tract. This condition is also called rapid gastric emptying. It is mostly associated with conditions following gastric or esophageal surgery, though it can also arise secondary to diabetes or to the use of certain medications; it is caused by an absent or insufficiently functioning pyloric sphincter, the valve between the stomach and the duodenum.
Colic in horses is defined as abdominal pain, but it is a clinical symptom rather than a diagnosis. The term colic can encompass all forms of gastrointestinal conditions which cause pain as well as other causes of abdominal pain not involving the gastrointestinal tract. What makes it tricky is that different causes can manifest with similar signs of distress in the animal. Recognizing and understanding these signs is pivotal, as timely action can spell the difference between a brief moment of discomfort and a life-threatening situation. The most common forms of colic are gastrointestinal in nature and are most often related to colonic disturbance. There are a variety of different causes of colic, some of which can prove fatal without surgical intervention. Colic surgery is usually an expensive procedure as it is major abdominal surgery, often with intensive aftercare. Among domesticated horses, colic is the leading cause of premature death. The incidence of colic in the general horse population has been estimated between 4 and 10 percent over the course of the average lifespan. Clinical signs of colic generally require treatment by a veterinarian. The conditions that cause colic can become life-threatening in a short period of time.
A volvulus is when a loop of intestine twists around itself and the mesentery that supports it, resulting in a bowel obstruction. Symptoms include abdominal pain, abdominal bloating, vomiting, constipation, and bloody stool. Onset of symptoms may be rapid or more gradual. The mesentery may become so tightly twisted that blood flow to part of the intestine is cut off, resulting in ischemic bowel. In this situation there may be fever or significant pain when the abdomen is touched.
Pyelogram is a form of imaging of the renal pelvis and ureter.
Whole bowel irrigation (WBI) is a medical process involving the rapid administration of large volumes of an osmotically balanced macrogol solution, either orally or via a nasogastric tube, to flush out the entire gastrointestinal tract.
Iohexol, sold under the trade name Omnipaque among others, is a contrast agent used for X-ray imaging. This includes when visualizing arteries, veins, ventricles of the brain, the urinary system, and joints, as well as during computed tomography. It is given by mouth, injection into a vein, or into a body cavity.
Barium sulfate suspension, often simply called barium, is a contrast agent used during X-rays. Specifically it is used to improve visualization of the gastrointestinal tract on plain X-ray or computed tomography. It is taken by mouth or used rectally.
An abdominal x-ray is an x-ray of the abdomen. It is sometimes abbreviated to AXR, or KUB.
A retrograde urethrography is a routine radiologic procedure used to image the integrity of the urethra. Hence a retrograde urethrogram is essential for diagnosis of urethral injury, or urethral stricture.
Metrizoic acid is a pharmaceutical drug that was used as an iodinated contrast medium for X-ray imaging. Its uses included angiography and urography, but it has been discontinued, at least in the US.
Iotalamic acid, sold under the brand name Conray, is an iodine-containing radiocontrast agent. It is available in form of its salts, sodium iotalamate and meglumine iotalamate. It can be given intravenously or intravesically.
Ioxaglic acid is pharmaceutical drug used as an iodinated contrast medium for X-ray imaging. It has low osmolality, typically resulting in fewer side effects than high-osmolality media. It is manufactured by Guerbet, but marketing in the US has been discontinued. As of 2021, it may still be available in some European countries.
Magnetic resonance enterography is a magnetic resonance imaging technique used to evaluate bowel wall features of both upper and lower gastro-intestinal tract, although it is usually used for small bowel evaluation. It is a less invasive technique with the advantages of no ionizing radiation exposure, multiplanarity and high contrast resolution for soft tissue.
Computed tomography enterography is a medical imaging technique which uses computed tomography scanner and contrast media to examine the small bowel. It was first introduced by Raptopoulos et al. in 1997. CT Enterography can be used to assess a variety of problems involving the small bowel, however it is mainly used to diagnose and assess severity of Crohn's disease.