Abstract

Objective: To report a rare case of vicarious contrast material excretion (VCME) following iodixanol administration, leading to acute kidney injury (AKI) and multi-organ complications, and to explore the underlying mechanisms.
Case presentation: A 71-year-old female underwent lower limb venography with intravenous iodixanol. Post-procedure, she developed AKI, followed by acute pancreatitis, hepatic hemorrhage, and hemoperitoneum. Imaging revealed contrast accumulation in the gallbladder and biliary tract, consistent with VCME.
Intervention and outcome: The patient was managed with hemodialysis, octreotide, transfusion, and supportive care. Laboratory and imaging improvements were observed by day 22, with successful discharge.
Conclusion: This case highlights the potential for iodixanol to induce VCME and subsequent multi-organ injury in the setting of AKI. Enhanced preoperative risk assessment, postoperative monitoring, and multidisciplinary management are essential for mitigating such rare but severe complications.

Author Details

Authors

• Le Li¹
• Lifang Yang²
• Huifeng Wu³
• Lin Chen⁴
• Zhouqian Jiang¹

Departments

• ¹ Department of Pharmacy, The People’s Hospital of Hezhou, Hezhou,
• ² Department of Basic Education and Research, Guidong Health School, Guangxi,
• ³ Department of Radiology, The People’s Hospital of Hezhou, Hezhou, and
• ⁴ Intensive Care Unit, The People’s Hospital of Hezhou, Hezhou, Guangxi, China

Address

Zhouqian Jiang, MD, Pharmacist-in-Charge
Department of Pharmacy
The People’s Hospital of Hezhou
No. 150, Xiyue Street, Babu District,
Hezhou City, Guangxi, China
Email: [email protected]

Citation