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CT Scan of the Abdomen and Pelvis: With and Without Contrast

What Is a CT Scan of the Abdomen or Pelvis?

The abdomen and pelvis contain the digestive organs as well as the urinary, endocrine, and reproductive systems.

A CT scan of this area may be done to look for abscesses, tumors, kidney stones, infections, or to try and uncover the cause of unexplained abdominal pain.

Abdominal scans can be used to help a doctor pinpoint the location of a tumor before a biopsy is performed.

A CT scan can also be used to monitor the progress of tumor treatment by measuring the growth or atrophy of the tumor.

Notice: This article is meant to give you a broad overview of what you might expect if you undergo a CT scan, with a definition and description of terms and procedures. Although I have an AD in radiography and a diploma in CT and MRI, which includes hands-on practical application in CT, I cannot give medical advice! If you have more questions about your procedure, please speak to your doctor or the technologists who will be performing the scan. I hope this is helpful!

Abdominal CT scan of an adult with autosomal dominant polycystic kidney disease. Extensive cyst formation is seen over both kidneys, with a few cysts in the liver as well.

Abdominal CT scan of an adult with autosomal dominant polycystic kidney disease. Extensive cyst formation is seen over both kidneys, with a few cysts in the liver as well.

What Are Some Symptoms That May Prompt an Abdominal or Pelvic CT Scan?

  • Unexplained abdominal pain and tenderness
  • Nausea, vomiting, or severe or chronic diarrhea
  • Unexplained fever
  • Unexplained weight loss
  • Urinary problems
  • Bowel changes
  • Trauma to the spleen, liver, kidneys, or other internal organs
  • Screening for metastatic cancers

Why Is Contrast Dye Used in a CT Scan?

The contrast makes it easier for the doctor to visualize different organs in the abdomen or pelvis. Contrast enhances the appearance of the specific organs, veins, or arteries the doctor wants to see. For example, contrast can be used to visualize the intestines, ureters, bladder, or pancreas.

Contrast is also known as "contrast dye," although there is no actual dye in it; it's only a substance that shows up very clearly on the scan.

If you are scheduled for an abdominal and/or pelvic exam with contrast, you will either drink an oral contrast, receive barium through a tube in the rectum, or have IV contrast injected through a vein.

What Is Oral Contrast?

The oral contrast used in CT scans will be either a barium sulfate drink or an iodine-based drink.

What the Doctor May Be Looking for With Oral Contrast:

  • Appendicitis
  • Cholecystitis
  • Diverticulitis
  • Bowel Obstruction
  • Tumor

Barium Sulfate

  • Barium sulfate is a chalky drink, made with a natural mineral, that is similar to some stomach remedies such as milk of magnesia. You will be given two bottles of the barium contrast to drink.
  • You will drink one bottle the night before your scan, the other the morning of the scan. This is done to ensure the upper and lower digestive organs are well coated with the barium contrast. You will be given detailed instructions on exactly when to drink the contrast when you pick up the contrast before your exam.
  • If you are scheduled to have an exam requiring a barium enema, the enema will be administered at the clinic.

Diatrizoic Acid (Gastrografin)

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  • Diatrizoic acid is used in place of barium when a patient is allergic to barium or when there is a chance the intestines or stomach have been perforated. It is not as thick as barium sulfate, but it has an unpleasant taste that may be slightly masked with flavoring.
  • Gastrografin will be given a few hours before the exam or, if delivered rectally, right before the exam.

What Is IV Contrast?

IV contrast is an iodine-based liquid that is injected during the exam into a vein or artificial port at a high flow rate. The contrast will then spread rapidly throughout all the vascular structures and organs in your body.

What the Doctor May be Looking for When Using IV contrast:

  • Aneurism
  • Tumors
  • Cysts
  • Cirrhosis
  • Impaired urine or blood flow
  • Cancer
Abdominal and pelvic CT scan showing duodenal compression.

Abdominal and pelvic CT scan showing duodenal compression.

Your doctor will order an abdominal or pelvic exam with IV contrast when he wants to get a detailed look at your:

  • liver
  • abdominal arteries or veins
  • kidneys
  • ureters
  • bladder
  • pancreas and other internal organs.

The doctor will consider your age and health before ordering an exam with IV contrast. You may have your blood drawn and analyzed beforehand to ensure you are healthy enough for the contrast.

When the contrast is injected, you may feel heat or warmth in the back of your throat. This sensation may spread down to your pelvis, making you feel as if you have wet yourself. You may also get a metallic taste in your mouth.

Tell the CT Tech or Your Doctor Immediately If You Experience These Symptoms After Receiving Contrast:

  • Hives or itching red skin
  • Difficulty breathing or swallowing
  • Swelling of the throat
  • Hoarseness
  • Agitation
  • Confusion
  • Bluish skin color

What is a CT Scan Without Contrast?

It is not always necessary to use contrast to see problems in the abdomen or pelvis. Contrast may actually obscure conditions or anatomy.

Contrast is not needed when looking at:

  • renal calculi (kidney stones)
  • the spine or bones of the pelvis
  • the intestines, when constipation is suspected.
  • retroperitoneal hematoma (blood clot behind the peritoneum).

When a person comes to the emergency department complaining of abdominal pain, many doctors will first order a CT scan without contrast to rule out severe constipation or appendicitis.

Acute colonic pseudo-obstruction, also called Ogilvie syndrome. The colon is massively dilated.

Acute colonic pseudo-obstruction, also called Ogilvie syndrome. The colon is massively dilated.

What Happens When You Get Scanned (Step-by-Step)

  • After checking in for your exam, you will be asked to remove your shirt, pants, and any piercings that may interfere with the CT image. If you are to receive IV contrast, you may have an IV needle inserted at this point.
  • You will then be taken to the CT exam room where you will see the actual machine. It is large, with a donut-shaped gantry and a long table that will move you in and out of the gantry.
  • You will be asked to lie face up on the table with your head facing away from the hole. If you are to receive IV contrast and haven't been prepped yet, you will be hooked up to the IV at this point.
  • The CT technician will explain what will happen and what you may experience. She will remind you that she will be able to see and hear you at all times.
  • You will be asked to rest your arms above your head, and then you and the table will be moved into position toward the gantry. You will only advance as far as mid-chest; your head will still be outside the machine.
  • The tech will leave the room and start the machine, which will make noise as the internal parts spin around you and the table. The machine will tell you to hold your breath as the table moves you out of the gantry. The machine will stop its backward movement, you will be told you can breathe again, and then the table will move you back to your original position in the gantry.
  • There will be a delay as the technician makes adjustments in the control room. Depending on how the doctor ordered the exam and whether you need IV contrast, you will move in and out once or twice more.
  • That's it! You're done. The table will move you out of the gantry and the tech will have you sit up. The IV needle, if any, will be removed and you will be reminded to drink plenty of fluids if you have received oral or IV contrast.
  • If you are taking certain medicines, you will be reminded not to take them for 48 hours.

Why Won't the CT Tech Give Me the Results of My Scan?

Many patients get frustrated with x-ray, CT, and other technicians because the techs will not tell the patients what the images reveal. There is a reason for this. Technicians are not trained to diagnose medical diseases or conditions; they are trained to use imaging equipment properly to obtain diagnostic-quality images.

While technicians are in fact able to identify many diseases and conditions, they are forbidden to discuss what they see with the patient. Only a doctor with many years of training should look at the images to make a diagnosis.

The images will be read by a radiologist, who will make a diagnosis. Your doctor will be notified, usually within 48 hours, and you will be contacted with the results. If the radiologist sees a condition that could be life-threatening, the reporting process will be much faster.

More Information

This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Questions & Answers

Question: I am scheduled for an abd/pelvic CT for possible bowel obstruction or carcinoid mass in 2 days. If my bowel is full will this affect the scan? I have not had a bowel movement in 10 days and have ingested a lot of food.

Answer: The scan will show if the bowel is full of feces or obstructed in some way.

Question: Can I see my renal CT scan after the procedure?

Answer: You are allowed to see all of your medical records. Ask the doctor or CT techs how to obtain a copy of your scan.

Question: can a CT scan of the abdomen and pelvis show fluid?

Answer: Yes it can.

Question: Is it better to get a CT scan with or without contrast?

Answer: Your doctor will decide whether using contrast is necessary based on your condition. Contrast is needed to visualize certain body parts.

Question: Can a ct scan show fallopian tubes conditions?

Answer: For a detailed look at the fallopian tubes, a hysterosalpingogram using fluoroscopy is best.

Question: Can a CT scan show fluid and ascites?

Answer: Yes, it can.

Question: Why would a physician change from a CT scan with contrast to one without contrast?

Answer: It may have been an error on the doctor's part, or there may have been a medical condition which prevented the use of contrast on the patient.

Question: Is an x-ray used for an abdomen/CT scan?

Answer: Yes, a CT scan uses x-rays.

Question: What happens if I get a CT with metformin in your system?

Answer: A possible, but rare, side effect can be lactic acidosis. Read this link for more information on the subject:

Question: Can an abdominal-pelvic Ct scan show testicle problems like epididymis or orchitis?

Answer: Yes, a pelvic Ct scan can show these problems, although ultrasound is the usual diagnostic technique.

Question: Will I need IV contrast for abdominal hemorrhage?

Answer: Contrast may be used for abdominal hemorrhage, but it will be up to your doctor if he/she deems it necessary.

© 2013 Gable Rhoads


Diana McLean on November 19, 2018:

I am scheduled for a ct scan with contrast. It is for cancer of which I have had a total hysterectomy. It is not because I have gastroparesis. They have told me when to drink the contrast, however, I am concerned with the gp, it won't reach the areas it should. Should I take contrast earlier.

Barbara Johnson on March 23, 2018:

thank you for your help. How long does this procedure tke? im very claustrophobic, so i am worried

James on March 21, 2018:

Mary, No it's not unusual. I had both the Barium oral drink and IV contrast with my scan.

Mary on March 12, 2018:

I am scheduled for CT with Barium and IV contrast. Is that unusual? I thought is was either or.

Linda on March 03, 2018:

Just want to know is there any side effects after.a ct scan with no contrast of the stomach. To check on kidney stones

lorann on January 27, 2018:

I just had a bladder and kidney ct scan without contrast and the doc called and said my stomach looked funny on that scan. Now wants to do a ct scan of stomach with contrast. Did the bladdar/kidney ct show my stomach too. I don't want anthcr ct scan a week apart. He says ultrasound won't do,

Joe on November 22, 2017:

I drank the 2 bottles of barium drink......reading the results of the test it states that it was a CT abdomen and pelvis, without contrast...........really confused wasn't the bottles of barium meant for contrast?

Gable Rhoads (author) from North Dakota on October 04, 2017:

Joe, it will be done as one scan.

Joe on October 04, 2017:

Is a CT scan of the abdomen /pelvis one CT Scan or two separate ones?


Darlene on September 01, 2017:

Thank You for the very detailed and clear information.

Bill S on August 17, 2017:

Thank you for this clearly written information. Very Helpful to understand the procedure

Gable Rhoads (author) from North Dakota on June 30, 2017:

Capt. Hastings, yes the appendix will show on the CT scan.

CaptHastings on June 25, 2017:

Very informative and wonderfully written article - thank you!

My elderly mother will be having the scan for undetermined abdominal pain. I've noticed recently that her hand immediately goes to her right side when that intermittent yet dreadful pain surfaces and stops her in her tracks, and my first thought is "appendix". Does CAT scan of abdomen and pelvis (w/ contrast) also capture the appendix? Thanks.

Gable Rhoads (author) from North Dakota on June 19, 2017:

Sherry, the oral contrast will highlight only the digestive tract, although the liver and kidneys will appear on the scan.

Marie on June 16, 2017:

I suffer from anxiety and need medication for can I take it b4 scan? I'm scheduled to take the oral contrast barium sulfate not looking forward to that what does it taste like?

Sherry on June 15, 2017:

If a person has pain in the stomach and sides will a ct scan of the stomach and pelvis show the kidneys and liver with oral contrast?

Abdul on March 23, 2017:

The information you gave are very helpful.

clevy on March 14, 2017:

This is far more than the doctor explained about a CT scan. Thank you!

Chris on January 31, 2017:

Thank you for this information. Very nice to know the process before I go in for my CT.

Gable Rhoads (author) from North Dakota on September 23, 2016:

I hope everything turns out well. I'm glad I could help.

Sophie on September 22, 2016:

I have a CT scan tomorrow and am very nervous. This helped explain a lot and put me at ease a bit. Thank you!

Gable Rhoads (author) from North Dakota on September 16, 2016:

Thank you for the nice words, Bill.

Bill on September 16, 2016:

Superbly written and concise information. Thanks for taking the time and trouble to do this.

Linda Robinson from Cicero, New York on June 10, 2016:

Hello Gable so nice meeting you. This hub is remarkable and is filled with much exceptional informative and helpful information. This is an excellent hub for anyone who has no idea what a CT scan is or what to expect. Super writing and awesome content. I look forward to reading many more of your hubs. Linda

Gable Rhoads (author) from North Dakota on February 02, 2016:

Thank you, Taran. It is also amazing how far we have come in just 40 years!

Marvel riveron on October 23, 2015:

thank you so was really helpful.

Gable Rhoads (author) from North Dakota on July 07, 2014:

Thank you for reading. :)

Gable Rhoads (author) from North Dakota on March 26, 2014:

Thank you. I'm glad I could help. :)

hothaifh on March 26, 2014:

this is great information

Gable Rhoads (author) from North Dakota on March 13, 2014:

You're welcome soujama.

soujamya on March 13, 2014:

thank you....

Gable Rhoads (author) from North Dakota on May 13, 2013:

Thank you for the support, Melinda. I like helping people feel at ease when facing a medical procedure.

mylindaelliott from Louisiana on May 13, 2013:

This is all great information. The pictures and videos are especially helpful. My mother was scared that she had to have a CT scan. This would have been very helpful.

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