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Bowel Angioedema Associated With Iodinated Contrast Media: Incidence and Predisposing Factors

 Seo, Nieun  ;  Chung, Yong Eun  ;  Lim, Joon Seok  ;  Song, Mi Kyung  ;  Kim, Myeong-Jin  ;  Kim, Ki Whang 
 Investigative Radiology, Vol.52(9) : 514-521, 2017 
Journal Title
 Investigative Radiology 
Issue Date
Angioedema/chemically induced* ; Angioedema/physiopathology ; Contrast Media/adverse effects* ; Female ; Humans ; Incidence ; Intestinal Diseases/chemically induced* ; Intestinal Diseases/physiopathology ; Iodine/adverse effects* ; Male ; Middle Aged ; Radiographic Image Enhancement/methods ; Retrospective Studies ; Tomography, X-Ray Computed/methods
OBJECTIVE: Bowel angioedema is an acute adverse reaction to iodinated contrast media (CM) that involves the gastrointestinal tract. We aimed to investigate the incidence and predisposing factors of iodinated CM-associated bowel angioedema during computed tomography (CT) examinations. MATERIALS AND METHODS: This study was approved by our institutional review board, and informed consent was waived due to its retrospective design. From July 2013 to July 2015, adult patients with a history of adverse reactions to iodinated CM during CT (group A, n = 427) and patients without adverse reactions matched for age and sex with the propensity-score matching method (group B, n = 427) were studied. Contrast media-associated bowel angioedema was determined when bowel wall thickness increased after contrast enhancement compared with the precontrast scan. Potential predisposing factors including patient demographics, symptoms and time of adverse reactions, and CM-related factors were compared between patients with and without angioedema in group A. In addition, the incidence of bowel angioedema was compared between groups A and B. RESULTS: The incidence of CM-associated bowel angioedema in group A was 3.3% (14/427) in the per-patient analysis and 2.6% (15/578) in the per-examination analysis. The CM-associated bowel angioedema involved the distal duodenum and/or proximal jejunum and showed long-segmental circumferential bowel wall thickening on CT. None of the studied predisposing factors was different between patients with and without bowel angioedema (P > 0.05). The incidence of CM-associated bowel angioedema in group B was 1.9% (8/427) and 1.7% (8/458) for per-patient and per-examination analyses, respectively, and these rates were not significantly different between groups A and B (P = 0.346 and P = 0.370, respectively). CONCLUSIONS: The incidence of CM-associated bowel angioedema during CT was 1.7% to 3.3%, and none of the studied predisposing factors was associated with bowel angioedema.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
Yonsei Authors
김기황(Kim, Ki Whang)
김명진(Kim, Myeong Jin) ORCID logo https://orcid.org/0000-0001-7949-5402
서니은(Seo, Nieun) ORCID logo https://orcid.org/0000-0001-8745-6454
임준석(Lim, Joon Seok) ORCID logo https://orcid.org/0000-0002-0334-5042
정용은(Chung, Yong Eun) ORCID logo https://orcid.org/0000-0003-0811-9578
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