Extravasation of Radiology contrast

Extravasation can occur during hand or power injection in 0.1%–0.9% of cases but is more common in the latter. The elderly, infants, children, patients with altered consciousness, and those with underlying vascular disease are more prone to extravasation. Small extravasations of contrast media usually produce a local inflammatory response in the skin, without serious sequela. Larger volumes (50–75 mL) may produce tissue damage from chemotoxicity or resultant compartment syndrome (19,20).

Patients usually present with persistent burning and swelling at the injection site. Assessment of the patient's pulse distal to the injection site and documentation of initial swelling and erythema are essential in early management. Smaller extravasations may be managed with elevation and cold compresses. In cases with persistent swelling, pain, and discoloration, it is best to consult a surgeon. Complications of contrast extravasation tend to be more severe with higher-osmolality contrast agents