Abdominal and pelvic CT: use of oral metoclopramide to enhance bowel opacification.

The value of orally administered metoclopramide hydrochloride to enhance bowel opacification during abdominal and pelvic computed tomography (CT) was analyzed prospectively in 202 patients in a control group and 334 patients in an experimental group who received 10 mg of metoclopramide with the first dose of oral contrast material. Five hundred milliliters of 2% sodium diatrizoate was given orally 45-60 minutes and 30 minutes before the study, and 250 mL was given 5-10 minutes before the study. Opacification of stomach, duodenum, and small and large bowels was graded from 0 to 3+, and the presence of pseudotumors or side effects from metoclopramide were noted. No significant difference was found in the opacification of stomach, duodenum, and jejunum between control and experimental studies. Opacification was significantly better in metoclopramide studies than control studies in the proximal ileum (P less than .05), distal ileum (P less than .05), right colon (P less than .05), and transverse colon (P less than .05). Pseudotumors were seen in 7% of control and 3% of experimental subjects. No side effects were encountered. Routine oral administration of metoclopramide before abdominal and pelvic CT examinations is recommended for rapid opacification of the ileum and proximal colon for all outpatients and for inpatients who must undergo CT on an emergency basis.