Value of CT in the discrimination of fatal from non-fatal stercoral colitis

Korean J Radiol. 2012 May-Jun;13(3):283-9. doi: 10.3348/kjr.2012.13.3.283. Epub 2012 Apr 17.

Abstract

Objective: Clinical presentation and physical signs may be unreliable in the diagnosis of stercoral colitis (SC). This study evaluates the value of computed tomography (CT) in distinguishing fatal from non-fatal SC.

Materials and methods: Ten patients diagnosed as SC were obtained from inter-specialist conferences. Additional 13 patients with suspected SC were identified via the Radiology Information System (RIS). These patients were divided into two groups; fatal and non-fatal SCs. Their CT images are reviewed by two board-certified radiologists blinded to the clinical data and radiographic reports.

Results: SC occurred in older patients and displayed no gender predisposition. There was significant correlation between fatal SC and CT findings of dense mucosa (p = 0.017), perfusion defects (p = 0.026), ascites (p = 0.023), or abnormal gas (p = 0.033). The sensitivity, specificity, and accuracy of dense mucosa were 71%, 86%, and 81%, respectively. These figures were 75%, 79%, and 77% for perfusion defects; 75%, 80%, and 78% for ascites; and 50%, 93%, and 78% for abnormal gas, respectively. Each CT sign of mucosal sloughing and pericolonic abscess displayed high specificity of 100% and 93% for diagnosing fatal SC, respectively. However, this did not reach statistical significance in diagnosing fatal SC.

Conclusion: CT appears to be valuable in discriminating fatal from non-fatal SC.

Keywords: Computed tomography; Fatality; Fecaloma; Stercoral colitis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chi-Square Distribution
  • Colitis / diagnostic imaging*
  • Colitis / mortality
  • Contrast Media
  • Diagnosis, Differential
  • Fecal Impaction / diagnostic imaging*
  • Fecal Impaction / mortality
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Sensitivity and Specificity
  • Statistics, Nonparametric
  • Tomography, X-Ray Computed / methods*

Substances

  • Contrast Media