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Diagnostic imaging can play a significant role in the management of many toxicologic emergencies. Radiographic studies can directly visualize the xenobiotic in some cases, but in others, they reveal the effects of the xenobiotic on various organ systems (Table 5–1). Radiography can confirm a diagnosis (e.g., by visualizing the xenobiotic), assist in therapeutic interventions such as monitoring gastrointestinal (GI) decontamination, and detect complications of the xenobiotic exposure.180

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Table 5–1. Xenobiotics with Diagnostic Imaging Findings

Conventional radiography is readily available in the emergency department (ED) and is the imaging modality most frequently used in acute patient management. However, other imaging modalities can be used in toxicologic emergencies, including computed tomography (CT); enteric and intravascular contrast studies; ultrasonography; transesophageal echocardiography (TEE); magnetic resonance imaging (MRI/MRA); and nuclear scintigraphy, including positron emission tomography (PET) and single-photon emission tomography (SPECT).


A number of xenobiotics are radiopaque and can potentially be detected by conventional radiography. Radiography is most useful when a substance that is known to be radiopaque has been ingested or injected. When the identity of ...

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