title: Detection of occult colonic perforation before CT colonography after incomplete colonoscopy: perforation rate and use of a low-dose diagnostic scan before CO2 insufflation.
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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Radiology, Mayo Clinic, 200 First St. SW, Charlton 2, Rochester, MN 55905, USA. Hough.David@mayo.edu
authors.forename: David M
authors.initials: DM
authors.lastname: Hough
authors.forename: Martin A
authors.initials: MA
authors.lastname: Kuntz
authors.forename: Jeff L
authors.initials: JL
authors.lastname: Fidler
authors.forename: C Daniel
authors.initials: CD
authors.lastname: Johnson
authors.forename: Bret T
authors.initials: BT
authors.lastname: Petersen
authors.forename: James M
authors.initials: JM
authors.lastname: Kofler
authors.forename: Joel G
authors.initials: JG
authors.lastname: Fletcher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002245:Carbon Dioxide; D023881:Colonography, Computed Tomographic; D003113:Colonoscopy / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D002245:Carbon Dioxide