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

AJR Am J Roentgenol. 2008 Oct;191(4):1077-81. doi: 10.2214/AJR.07.2746.

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 CO(2) 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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carbon Dioxide*
  • Colonography, Computed Tomographic*
  • Colonoscopy / adverse effects*
  • Colonoscopy / methods*
  • Female
  • Humans
  • Intestinal Perforation / diagnostic imaging*
  • Intestinal Perforation / etiology*
  • Male
  • Middle Aged
  • Tomography, X-Ray Computed / methods*

Substances

  • Carbon Dioxide