Detection of occult colonic perforation before CT colonography after incomplete colonoscopy: Perforation rate and use of a low-dose diagnostic scan before CO2 insufflation

David M. Hough, Martin A. Kuntz, Jeff L. Fidler, C. Daniel Johnson, Bret Thomas Petersen, James M. Kofler, Joel Garland Fletcher

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15 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this study was to obtain a low-dose CT scan before CT colonography to estimate the prevalence of occult colonic perforation among patients referred for same-day or next-day CT colonography after incomplete colonoscopy. MATERIALS AND METHODS. Two hundred sixty-two patients (74 men, 188 women; mean age, 64 years; range, 21-92 years) consecutively referred for same-day or next-day CT colonography after incomplete colonoscopy underwent low-dose diagnostic CT before rectal tube insertion and CO2 insufflation. RESULTS. Perforation was found on the low-dose CT scans of two of the 262 patients (0.8%; 95% CI, 0.1-2.7%). One of these patients had no symptoms; the other had mild abdominal discomfort at the time of CT. CONCLUSION. The rate of occult colonic perforation after incomplete colonoscopy may be significant. For patients referred for CT colonography after incomplete endoscopy, use of low-dose diagnostic CT before rectal tube insertion and insufflation is indicated.

Original languageEnglish (US)
Pages (from-to)1077-1081
Number of pages5
JournalAmerican Journal of Roentgenology
Volume191
Issue number4
DOIs
StatePublished - Oct 2008

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Computed Tomographic Colonography
Insufflation
Colonoscopy
Endoscopy

Keywords

  • Colon
  • Colonography
  • Colonoscopy
  • CT colonography
  • Perforation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

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title = "Detection of occult colonic perforation before CT colonography after incomplete colonoscopy: Perforation rate and use of a low-dose diagnostic scan before CO2 insufflation",
abstract = "OBJECTIVE. The purpose of this study was to obtain a low-dose CT scan before CT colonography to estimate the prevalence of occult colonic perforation among patients referred for same-day or next-day CT colonography after incomplete colonoscopy. MATERIALS AND METHODS. Two hundred sixty-two patients (74 men, 188 women; mean age, 64 years; range, 21-92 years) consecutively referred for same-day or next-day CT colonography after incomplete colonoscopy underwent low-dose diagnostic CT before rectal tube insertion and CO2 insufflation. RESULTS. Perforation was found on the low-dose CT scans of two of the 262 patients (0.8{\%}; 95{\%} CI, 0.1-2.7{\%}). One of these patients had no symptoms; the other had mild abdominal discomfort at the time of CT. CONCLUSION. The rate of occult colonic perforation after incomplete colonoscopy may be significant. For patients referred for CT colonography after incomplete endoscopy, use of low-dose diagnostic CT before rectal tube insertion and insufflation is indicated.",
keywords = "Colon, Colonography, Colonoscopy, CT colonography, Perforation",
author = "Hough, {David M.} and Kuntz, {Martin A.} and Fidler, {Jeff L.} and Johnson, {C. Daniel} and Petersen, {Bret Thomas} and Kofler, {James M.} and Fletcher, {Joel Garland}",
year = "2008",
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AU - Kuntz, Martin A.

AU - Fidler, Jeff L.

AU - Johnson, C. Daniel

AU - Petersen, Bret Thomas

AU - Kofler, James M.

AU - Fletcher, Joel Garland

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N2 - OBJECTIVE. The purpose of this study was to obtain a low-dose CT scan before CT colonography to estimate the prevalence of occult colonic perforation among patients referred for same-day or next-day CT colonography after incomplete colonoscopy. MATERIALS AND METHODS. Two hundred sixty-two patients (74 men, 188 women; mean age, 64 years; range, 21-92 years) consecutively referred for same-day or next-day CT colonography after incomplete colonoscopy underwent low-dose diagnostic CT before rectal tube insertion and CO2 insufflation. RESULTS. Perforation was found on the low-dose CT scans of two of the 262 patients (0.8%; 95% CI, 0.1-2.7%). One of these patients had no symptoms; the other had mild abdominal discomfort at the time of CT. CONCLUSION. The rate of occult colonic perforation after incomplete colonoscopy may be significant. For patients referred for CT colonography after incomplete endoscopy, use of low-dose diagnostic CT before rectal tube insertion and insufflation is indicated.

AB - OBJECTIVE. The purpose of this study was to obtain a low-dose CT scan before CT colonography to estimate the prevalence of occult colonic perforation among patients referred for same-day or next-day CT colonography after incomplete colonoscopy. MATERIALS AND METHODS. Two hundred sixty-two patients (74 men, 188 women; mean age, 64 years; range, 21-92 years) consecutively referred for same-day or next-day CT colonography after incomplete colonoscopy underwent low-dose diagnostic CT before rectal tube insertion and CO2 insufflation. RESULTS. Perforation was found on the low-dose CT scans of two of the 262 patients (0.8%; 95% CI, 0.1-2.7%). One of these patients had no symptoms; the other had mild abdominal discomfort at the time of CT. CONCLUSION. The rate of occult colonic perforation after incomplete colonoscopy may be significant. For patients referred for CT colonography after incomplete endoscopy, use of low-dose diagnostic CT before rectal tube insertion and insufflation is indicated.

KW - Colon

KW - Colonography

KW - Colonoscopy

KW - CT colonography

KW - Perforation

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