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Implications of Computerized Tomography Colonography in Fully Intended but Aborted Optical Colonoscopy - a

Constanze Jakob1,2, Thomas Arens3, Annett Borkenhagen4

  • 1Friedrich Schiller University, Jena, Germany.

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|December 9, 2025
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Summary
This summary is machine-generated.

CT colonography (CTC) is an alternative when optical colonoscopy (OC) is incomplete. This study found CTC has limited value for detecting significant findings after aborted OC, suggesting restricted use.

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Area of Science:

  • Gastroenterology
  • Radiology
  • Colorectal Surgery

Background:

  • Optical colonoscopy (OC) is a primary tool for colorectal examination.
  • Incomplete OC necessitates alternative diagnostic strategies.
  • CT colonography (CTC) may serve as a follow-up examination after failed OC.

Purpose of the Study:

  • To evaluate the implications of CT colonography (CTC) following incomplete optical colonoscopy (OC).
  • To compare surgical and interventional endoscopic outcomes between patients who underwent CTC after aborted OC and those who completed OC.
  • To assess the diagnostic yield of CTC in patients with previously unsuccessful OC.

Main Methods:

  • Retrospective chart review comparing 302 patients who had CTC after incomplete OC with sex-matched controls who completed OC.
  • Analysis of indications for OC, reasons for discontinuation, and detection rates.
  • Evaluation of extracolonic findings identified on CTC.

Main Results:

  • Common reasons for OC discontinuation included suspected adhesions and sigmoid colon anatomy.
  • Adenoma detection rates were significantly lower in the CTC group (9.6%) compared to the control group (26.9%) for preventive colonoscopies.
  • CTC identified numerous extracolonic findings, but few were potentially malignant and fewer were histologically confirmed.

Conclusions:

  • CT colonography (CTC) after incomplete optical colonoscopy (OC) yielded a low rate of significant (pre)malignant findings.
  • The study suggests a limited role for CTC in this setting, emphasizing case-by-case consideration based on indication and reasons for OC failure.
  • Further investigation into the utility of CTC as an alternative to repeat OC is warranted.