Major Reactions to Intravenous Urographic Media

With improved radiologic techniques and better contrast media, intravenous urography has become one of the "routine" tests frequently employed in a general physical examination. Although it is not my purpose to minimize the value of this procedure in urologic diagnosis, I wish to emphasize that the intravenous injection of any iodine-containing compound is not without danger. Therefore, intravenous urography should be employed in only those cases in which a definite clinical indication exists. I wish to report six serious reactions following intravenous pyelography, two of which terminated fatally. These reactions occurred in a series of 12,000 urograms in which sodium acetrizoate (Urokon) was used. Barry and Rose¹ reported two hypotensive reactions, and Porporis and co-workers² reported another that occurred early in this series.

In 1942 and again in 1954, Pendergrass * canvassed urologists and radiologists concerning severe or fatal reactions to various intravenous urographic media. Including his own cases,