Is the Six-hour Fasting before Abdominal Computed Tomography Necessary to Prevent Gastrointestinal Adverse Events in Patients with Abdominal Pain?

Park,  Jung Ho; Rhee,  Joong Eui; Kim,  Kyu Seok; Shin,  Jung Ho

J Korean Soc Emerg Med > Volume 19(3); 2008 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2008;19(3): 333-338.

Is the Six-hour Fasting before Abdominal Computed Tomography Necessary to Prevent Gastrointestinal Adverse Events in Patients with Abdominal Pain?

Jung Ho Park, Joong Eui Rhee, Kyu Seok Kim, Jung Ho Shin

¹Department of Emergency Medicine, Seoul National University Hospital, Korea.
²Department of Emergency Medicine, Seoul National University Bundang Hospital, Korea. rheeje@gmail.com
³Department of Emergency Medicine, Korea University Anam Hospital, Korea.

ABSTRACT

PURPOSE:
We tried to determine whether six-hour fasting before abdominal computed tomography (CT) scan is necessary to prevent aspiration of gastric contents in patients with acute abdominal pain.
METHODS:
Adult patients with acute abdominal pain who were checked abdominal CT were enrolled. Exclusion criteria were age <15 years, pregnancy, traumatic cause of symptoms, chronic pain(>7 days), renal impairment and hypersensitivity to contrast media. We compared Group-I (<6-hour fasting) with Group-II(> or =6-hour fasting). We collected the demographic and clinical data on the causes of abdominal pain, pain duration, presence of nausea and vomiting, and use of medications before and after abdominal CT. In order to estimate the volume of gastric contents, we measured the area on the CT image which showed the largest volume of gastric contents.
RESULTS:
Among the 122 patients, Group-I consisted of 38 patients(31.1%) and Group-II included 84(68.9%). The demographic makeups of the two groups were similar, except for gender proportion (more males in Group-I). Group-I showed significantly greater gastric contents compared than Group-II(46.8+/-32.1 vs. 33.7+/-28.3, p=0.024). A slightly negative correlation (r=-0.2313; 95% CI=-0.3929 to -0.0559) was observed between the fasting time and the volume of gastric contents. However, the frequencies of the nausea [13/38 (34.2%) vs. 26/84 (31%), p=0.721] and vomiting [6/38 (15.8%) vs. 18/84 (21.4%), p=0.468] showed no difference between two groups. There were no aspiration events in either groups.
CONCLUSION:
Six hours of fasting before abdominal CT may not be required to prevent aspiration of gastric contents in patients with acute abdominal pain.

Key words: Acute abdomen, Fasting, Spiral computed Tomography, Contrast media, Aspiration of gastric contents