A CT scan of the abdomen and pelvis with contrast (also called a contrast CT) is an imaging test that uses X-rays and a computer to create detailed cross-sectional pictures of the organs, blood vessels, and bones in your belly (abdomen) and pelvic region. “With contrast” means a special dye (contrast material) is used—most commonly an iodine-based dye given through an IV—to help certain tissues and blood vessels show up more clearly on the scan.

This test helps doctors look closely at structures such as the liver, gallbladder, pancreas, spleen, kidneys, stomach, intestines (including the appendix), bladder, prostate or uterus/ovaries, lymph nodes, and major blood vessels. Compared with a non-contrast CT, a contrast-enhanced CT can better show inflammation, infection, tumors, bleeding, and abnormal blood flow.

What it measures/looks for: The scan does not “measure” a blood level like a lab test; instead, it evaluates the size, shape, and appearance of organs and detects abnormalities such as an abdominal mass, enlarged lymph nodes, fluid collections, abscesses, kidney stones (sometimes), bowel inflammation, or internal bleeding. It can also help assess whether a mass looks benign or suspicious and whether disease has spread.

What results mean (plain language): A “normal” result generally means the organs and blood vessels look typical and no concerning masses, blockages, bleeding, or signs of infection are seen. An “abnormal” result might indicate swelling or inflammation (such as appendicitis or diverticulitis), infection (like an abscess), a blockage (such as a bowel obstruction), injury to an organ after trauma, or a growth that needs follow-up (for example, a tumor or cyst). Your report may describe the location, size, and characteristics of any findings and may recommend additional tests (like ultrasound, MRI, colonoscopy, or biopsy) or follow-up imaging.

Doctors commonly order a CT abdomen and pelvis with IV contrast when symptoms or exam findings suggest a problem inside the abdomen or pelvis that needs quick, detailed imaging. It is especially useful in urgent situations because it can evaluate many organs at once.

This test is often ordered for symptoms such as:

• Persistent or severe abdominal pain (right lower, left lower, upper abdomen, or generalized)
• New or unexplained pelvic pain
• A lump or suspected abdominal mass, bloating, or increasing abdominal size
• Fever with abdominal tenderness (possible infection or abscess)
• Nausea/vomiting with concern for bowel obstruction
• Unexplained weight loss or loss of appetite
• Blood in urine (hematuria) or suspected kidney/urinary tract issues
• Changes in bowel habits, severe constipation, or concern for colitis
• Evaluation after injury/trauma to look for internal bleeding or organ damage

It may also be done to:

• Investigate abnormal findings from other tests (ultrasound, X-ray, lab results)
• Diagnose or stage cancer and check whether it has spread to lymph nodes or nearby organs
• Monitor known conditions (for example, tumors, inflammatory bowel disease, kidney problems) or track response to treatment
• Guide procedures such as drainage of an abscess or biopsy planning

Important safety notes: CT uses ionizing radiation. IV contrast helps accuracy but is not right for everyone. Tell your clinician if you have a history of contrast allergy, asthma, prior reaction to iodine contrast, kidney disease, dehydration, or if you take medications that affect kidney function. If you have diabetes and take metformin, you may be given specific instructions around the time of the scan. You may also be asked about pregnancy, because radiation exposure is avoided in pregnancy unless absolutely necessary.

• Appendicitis
• Diverticulitis
• Bowel obstruction or ileus
• Kidney stones and urinary tract obstruction (hydronephrosis)
• Kidney infection (pyelonephritis) and complicated urinary tract infection
• Abdominal or pelvic abscess
• Inflammatory bowel disease (Crohn’s disease, ulcerative colitis)
• Pancreatitis and pancreatic complications
• Gallbladder inflammation (cholecystitis) and biliary obstruction
• Liver disease and liver lesions (cysts, tumors, metastases)
• Abdominal and pelvic cancers (colon, kidney, bladder, ovarian, uterine, prostate, pancreatic)
• Enlarged lymph nodes (lymphadenopathy) and lymphoma evaluation
• Hernias (certain types and complications)
• Internal bleeding or organ injury after trauma (liver/spleen/kidney injury)
• Abdominal aortic aneurysm (AAA) and other vascular abnormalities (in selected protocols)

• Finding the cause of unexplained abdominal pain or persistent digestive symptoms
• Clarifying or characterizing an abdominal mass or pelvic mass found on exam or ultrasound
• Early detection and staging of suspected abdominal or pelvic cancer
• Monitoring treatment response for cancer, infection, or inflammatory disease
• Evaluating complications and helping guide next steps (surgery vs. medication vs. drainage)
• Assessing internal injury after trauma to support safe, timely care
• Planning procedures and follow-up imaging in a personalized care plan