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Benign colorectal neoplasms undetected by colonoscopy
D W Gelfand1, M Y Chen, D J Ott
1Department of Radiology, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27157.
Gastrointestinal Radiology
|January 1, 1992
Summary
Colonoscopy detected 85% of colonic polyps previously identified by barium enema. This study highlights a 15% miss rate for colonoscopy in polyp detection, consistent with other findings.
Area of Science:
- Gastroenterology
- Radiology
- Medical Imaging
Background:
- Colonoscopy is a primary tool for detecting colonic polyps.
- Barium enema examination is an alternative imaging modality for polyp detection.
- Assessing the comparative sensitivity of these methods is crucial for diagnostic accuracy.
Purpose of the Study:
- To evaluate the sensitivity of colonoscopy in detecting colonic polyps previously identified via barium enema.
- To determine the false-negative rate of colonoscopy for polyp detection.
Main Methods:
- Retrospective analysis of 77 patients with 106 polypoid lesions initially identified by barium enema.
- Inclusion criteria for lesions: visible attachment, no movement, and confirmed polyp diagnosis by radiologists.
- Comparison of barium enema findings with colonoscopy results.
Main Results:
- Colonoscopy demonstrated an 85% sensitivity for detecting colonic polyps.
- Sixteen lesions (15%) identified by barium enema were not found during colonoscopy.
- Missed lesions were predominantly located in the left colon.
Conclusions:
- Colonoscopy has an 85% sensitivity for detecting colonic polyps, with a 15% false-negative rate.
- The miss rate is comparable to radiologic detection errors.
- Findings suggest potential areas for improving endoscopic examination, particularly in the left colon.