Colonoscopic assessment of radiologic strictures of the colon

The authors studied 47 patients with radiologic evidence of stricture to determine whether colonoscopy in this situation increased the accuracy of diagnosis and how this procedure might influence patient management. Colonoscopy increased to 81% the diagnostic accuracy, which was established at 38% with the single-contrast enema. Failure of both techniques to establish a precise diagnosis was 19%. From the clinical and radiologic data, surgical exploration for the 47 strictures would have been necessary in 28, not indicated in 9, and indicated solely for diagnostic purposes in 10. The addition of colonoscopy prevented unnecessary laparotomy in 5 (18%) of the first group and in 8 (80%) of the last. The authors conclude that colonoscopy should be complementary to the standard radiologic examination for colonic strictures, especially when carcinoma is suspected or if roentgenography does not provide a definitive diagnosis.