ARRT Patient Care Practice Exam

When performing a contrast medium GI series on a patient with a perforated ulcer, which of the following is the best option?

1. Thick barium sulfate suspension

2. Water-soluble iodinated media

3. Thin barium sulfate suspension

4. Oil-based iodinated media

The correct answer is: Water-soluble iodinated media

When dealing with a patient who has a perforated ulcer, the use of water-soluble iodinated media is the safest and most appropriate choice. In the event of a perforation, there is a significant risk that the contrast medium could leak into the peritoneal cavity. Water-soluble iodinated contrast agents are designed for such situations because they can be absorbed by the body and do not cause serious complications if they extravasate into the surrounding tissues or cavities. This characteristic allows for safer imaging in cases of perforation. Additionally, should the patient need surgery, the use of these iodinated agents does not complicate the surgical process as much as other substances might. Other types of contrast agents, such as thick or thin barium sulfate suspensions, pose a significant risk in patients with perforations. If barium were to leak into the abdominal cavity, it could lead to severe complications such as chemical peritonitis or adhesion formation, both of which could complicate patient recovery and treatment. Oil-based iodinated media might also pose risks due to their viscosity and potential for complications in the setting of gastrointestinal perforation. Therefore, using water-soluble iodinated media is the most sensible and safe option for conducting imaging in this scenario.