The renal excretion of contrast injected during endoscopic retrograde cholangiopancreatography (ERCP) has been described as an uncommon event. Patients with this phenomenon have been considered at increased risk of acute pancreatitis, but idiosyncratic reactions from this intravascular contrast have been discounted as nonexistent. Thirteen patients underwent noncontrast abdominal computed tomography (CT) before ERCP and noncontrast CT plus abdominal radiography immediately after ERCP. Renal excretion of ERCP-injected contrast was seen in two patients on abdominal films and in nine patients by CT. All patients had normal renal function and none developed clinical pancreatitis. Renal excretion of ERCP-injected contrast is much more common than previously suspected. Iodine allergy and possible reaction should be considered when performing this procedure.
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