BACKGROUND: Computed tomographic (CT) colonography (or 'virtual' colonoscopy) has become an increasingly popular tool for colorectal cancer screening. Colonic perforation, an uncommon complication, is a risk that has not been widely reported. METHODS: A systematic review of the literature was undertaken to identify all reported risk factors for colonic perforation following CT colonography. In addition, a retrospective multicentre study was undertaken, evaluating all CT colonographies in 10 major metropolitan tertiary referral centres. All colonic perforations were assessed for risk factors. RESULTS: A range of 'patient'-related and 'procedure'-related risk factors were identified in the literature. Among 3458 CT colonographies, there were two cases of colonic perforation contributing to an incidence of perforation of 0.06%. There was no statistical correlation between the incidence of perforation and institutional experience (P = 0.66). Risk factors common to both cases and the literature included age, recent colonoscopy and manual colonic insufflation. Diverticular disease and recent colonic biopsy were also notable factors. CONCLUSION: There is a small but real risk of perforation following CT colonography. Patient selection and preventative procedural measures may reduce this risk. The importance of the consent process is emphasized.
BACKGROUND: Computed tomographic (CT) colonography (or 'virtual' colonoscopy) has become an increasingly popular tool for colorectal cancer screening. Colonic perforation, an uncommon complication, is a risk that has not been widely reported. METHODS: A systematic review of the literature was undertaken to identify all reported risk factors for colonic perforation following CT colonography. In addition, a retrospective multicentre study was undertaken, evaluating all CT colonographies in 10 major metropolitan tertiary referral centres. All colonic perforations were assessed for risk factors. RESULTS: A range of 'patient'-related and 'procedure'-related risk factors were identified in the literature. Among 3458 CT colonographies, there were two cases of colonic perforation contributing to an incidence of perforation of 0.06%. There was no statistical correlation between the incidence of perforation and institutional experience (P = 0.66). Risk factors common to both cases and the literature included age, recent colonoscopy and manual colonic insufflation. Diverticular disease and recent colonic biopsy were also notable factors. CONCLUSION: There is a small but real risk of perforation following CT colonography. Patient selection and preventative procedural measures may reduce this risk. The importance of the consent process is emphasized.
Authors: Luis F Lara; Danny Avalos; Huan Huynh; Brenda Jimenez-Cantisano; Mariann Padron; Ronnie Pimentel; Tolga Erim; Alison Schneider; Andrew Ukleja; Albert Parlade; Fernando Castro Journal: United European Gastroenterol J Date: 2015-08 Impact factor: 4.623
Authors: Patrick D McLaughlin; Kevin P Murphy; Lee Crush; Owen J O'Connor; Joseph P Coyle; Cressida R Brennan; Attiya Suhail; Denis Kelly; Michael M Maher Journal: Radiol Res Pract Date: 2013-12-18
Authors: Alex Ghanouni; Steve Halligan; Andrew Plumb; Darren Boone; Jane Wardle; Christian von Wagner Journal: Eur Radiol Date: 2014-05-13 Impact factor: 5.315