Choosing contrast media for pediatric gastrointestinal examinations.

The availability of the new low osmolality contrast agents during the last few years has necessitated a reconsideration of which is the most appropriate contrast agent to utilize in the gastrointestinal (GI) tract. There are some clinical situations in which these new agents have become the contrast media of choice (e.g., evaluation of suspected necrotizing enterocolitis, evaluation of suspected bowel perforation). There are many other clinical situations in which one needs to weigh the potential benefits of the new agents against significantly increased costs. This report reviews in detail the available contrast agents for studying the GI tract and outlines the advantages and disadvantages of each agent. The new agents are compared with existing agents such as barium and the hypertonic water soluble agents (e.g., gastrografin, hypaque, conray, etc.). Guidelines for the use of each agent are presented.