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CT Colonography in Patients Who Have Undergone Sigmoid Colostomy: A Feasibility Study.
MedLine Citation:
PMID:  21940536     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to evaluate the technical feasibility of CT colonography of patients who have undergone sigmoid colostomy after abdominoperineal resection. MATERIALS AND METHODS: Seven men and 11 women (mean age, 57.2 ± 14.5 [SD] years) who had undergone abdominoperineal resection with sigmoid colostomy for rectal cancer were included. Colonic cleansing and fecal tagging were performed with magnesium citrate and 5% weight/volume barium. A conventional small rectal catheter with a retention balloon was introduced into the colonic stoma. An inflated balloon (15-25 mL) was positioned several centimeters beneath the skin. The interposed tissue acted as the mechanism for preventing balloon expulsion during colonic insufflation with carbon dioxide. Unenhanced right decubitus and contrast-enhanced supine images were obtained. Air-fluid leak, balloon expulsion, complications, and colonic distention evaluated on a 4-point scale in which 1 was the worst and 4 the best and mucosal coverage were assessed. RESULTS: Examinations were performed uneventfully for all but one patient, who had temporary air and fluid leakage. The mean amount of carbon dioxide used was 2.64 ± 0.64 L. In the right decubitus position, the mean distention grade of each colonic segment was 2.7 ± 1.1 (sigmoid), 3.4 ± 0.6 (descending), 3.6 ± 0.5 (transverse), 3.6 ± 0.5 (ascending), and 3.7 ± 0.5 (cecum). In the supine position the mean grades were 2.7 ± 1.2, 3.1 ± 0.7, 3.7 ± 0.5, 3.7 ± 0.5, and 3.8 ± 0.4. Four patients (22.2%) had segments not adequately visualized in either position owing to luminal collapse; all of these segments were in the sigmoid colon. Three patients (16.7%) had areas submerged under fecal matter in both positions, but these areas were evaluable because of fecal tagging or IV contrast enhancement. CONCLUSION: CT colonographic examination through a sigmoid stoma was technically feasible with currently available instruments, but further improvements in technique are needed.
Authors:
Ju Hee Lee; Seong Ho Park; Seung Soo Lee; Ah Young Kim; Jin Cheon Kim; Chang Sik Yu; Hyun Kwon Ha
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  197     ISSN:  1546-3141     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-9-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  W653-W657     Citation Subset:  -    
Affiliation:
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Asanbyeongwon-gil 86, Songpa-Gu, Seoul 138-736, Korea.
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