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Related Experiment Videos

Immediate CT pneumocolon for failed colonoscopy; comparison with routine pneumocolon.

I Britton1, S Dover, R Vallance

  • 1Department of Radiology, Pilgrim Hospital, Sibsey Road, Boston, UK. Ingrid.Britton@ULH.NHS.UK

Clinical Radiology
|February 27, 2001
PubMed
Summary

Computed tomography (CT) pneumocolon is a reliable diagnostic tool for colonic malignancy, offering high sensitivity and specificity. It serves as a valuable alternative when colonoscopy is incomplete, especially in frail patients.

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Area of Science:

  • Radiology
  • Gastroenterology
  • Oncology

Background:

  • Accurate diagnosis of colonic malignancy is crucial for timely treatment.
  • Colonoscopy is the gold standard but can be incomplete in some patients.
  • Alternative imaging modalities are needed to assess large bowel pathology.

Purpose of the Study:

  • To evaluate the diagnostic role and reliability of 2D CT pneumocolon for colonic malignancy.
  • To compare the feasibility of CT pneumocolon across different referral sources.
  • To assess CT pneumocolon's effectiveness as an alternative to barium enema and in cases of incomplete colonoscopy.

Main Methods:

  • Prospective study of 50 patients with suspected large bowel malignancy.
  • Patients underwent bowel preparation, air insufflation, and contrast-enhanced CT.

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  • Results were correlated with pathology, colonoscopy, barium enema, ERCP, and clinical follow-up.

    • Main Results:

    • Diagnostic images were obtained in 86% of patients.
    • CT pneumocolon demonstrated 100% sensitivity for lesions >1.5 cm and 94% specificity for structural abnormalities.
    • It achieved 82% specificity for correctly identifying malignancy, with some false positives.

    Conclusions:

    • CT pneumocolon is a reliable alternative to barium enema, particularly when colonoscopy is incomplete.
    • It offers extraluminal screening and proximal bowel examination advantages.
    • This technique is a valuable diagnostic tool for frail elderly or unfit patients.