Enteral contrast administration in abdominal computed tomography – Expert recommendations from the Abdominal Workgroup of the German Roentgen Society

Abstract

Purpose

There is a lack of clear recommendations regarding enteral contrast agent administration in the context of abdominal computed tomography (CT). A survey among members of the German Radiological Society (DRG) identified a very heterogeneous and indication-specific approach in the clinical routine. The goal of this study is to develop generally applicable recommendations.

Materials and Methods

Recommendations for enteral contrast agent administration were developed by members of the Abdominal Workgroup within the DRG, using methodology comparable to that of an S1 guideline with informal consensus. Relevant clinical indications were systematically identified, categorized, and assessed considering current evidence in the literature and guidelines.

Results and Conclusion

There are specific clinical scenarios in which enteral contrast is indicated. Respective recommendations are presented in terms of good clinical practice (GCP). In this context, especially the administration of positive enteral contrast agents for abdominal CT examination is obsolete for many clinical indications.

Key Points

• For many indications, enteral contrast agent administration is not necessary

• In the case of esophageal or gastric tumors, enteral contrast should be achieved using the “hydro-technique”

• Positive enteral contrast agents are primarily recommended for diagnosis of gastrointestinal fistulas and anastomoses

Citation Format

• Stadelmann J, Grenacher L, Juchems MS et al. Enteral contrast administration in abdominal computed tomography – Expert recommendations from the Abdominal Workgroup of the German Roentgen Society. Rofo 2025; DOI 10.1055/a-2750-0204

Keywords

abdomen - contrast agents - recommendations

Publication History

Received: 06 August 2025

Accepted after revision: 10 November 2025

Article published online:
08 December 2025

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