结肠镜检查不完全后CT结肠成像前隐匿性结肠穿孔的检测：穿孔率及二氧化碳注入前低剂量诊断性扫描的应用
Detection of occult colonic perforation before CT colonography after incomplete colonoscopy: perforation rate and use of a low-dose diagnostic scan before CO2 insufflation.
作者信息
Hough David M, Kuntz Martin A, Fidler Jeff L, Johnson C Daniel, Petersen Bret T, Kofler James M, Fletcher Joel G
机构信息
Department of Radiology, Mayo Clinic, 200 First St. SW, Charlton 2, Rochester, MN 55905, USA.
出版信息
AJR Am J Roentgenol. 2008 Oct;191(4):1077-81. doi: 10.2214/AJR.07.2746.
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.
目的
本研究的目的是在结肠CT成像前进行低剂量CT扫描，以评估在结肠镜检查不完全后当日或次日接受结肠CT成像的患者中隐匿性结肠穿孔的患病率。
材料与方法
262例患者（74例男性，188例女性；平均年龄64岁；范围21 - 92岁）在结肠镜检查不完全后连续接受当日或次日结肠CT成像，在插入直肠管和注入二氧化碳前接受低剂量诊断性CT扫描。
结果
262例患者中有2例在低剂量CT扫描中发现穿孔（0.8%；95%可信区间，0.1 - 2.7%）。其中1例患者无症状；另1例在CT检查时有轻度腹部不适。
结论
结肠镜检查不完全后隐匿性结肠穿孔的发生率可能较高。对于内镜检查不完全后接受结肠CT成像的患者，在插入直肠管和注入气体前使用低剂量诊断性CT是必要的。
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