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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
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.
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.
- 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.