title: Should air contrast computed tomography become the first investigation of the colon of frail or elderly patients?
abstract: OBJECTIVE
  Air contrast computed tomography (ACCT) is an alternative test to barium enema or colonoscopy. We review our experience of this test as the first investigation of frail, elderly patients with lower gastrointestinal symptoms, and record the subsequent clinical course of these patients to evaluate the efficacy of the technique.
  
  
  METHODS
  We performed 109 ACCT studies on frail patients aged 70 years or over with lower gastrointestinal symptoms. The findings were correlated with subsequent investigations and surgical findings. Patients with normal scans were followed up in out-patients or by their GP. Average follow up was 17 months.
  
  
  RESULTS
  A good quality complete examination of the colon was achieved in 97% of patients. Of 109 examinations 34 (31%) were reported as normal, 65 (60%) as diverticular disease, nine (8%) as demonstrating a colonic malignancy and one (1%) showed a benign polyp. One sigmoid tumour was missed initially but diagnosed on a repeat ACCT study.
  
  
  CONCLUSIONS
  ACCT is a reliable, well-tolerated technique in elderly frail patients.
authors.affiliation: Department of Radiology, Royal Free Hospital, London, UK Department of Surgery, Royal Free Hospital, London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Murray
authors.forename: G
authors.initials: G
authors.lastname: Hellawell
authors.forename: R
authors.initials: R
authors.lastname: Oakley
authors.forename: K
authors.initials: K
authors.lastname: Rosenfeld
authors.forename: R A
authors.initials: RA
authors.lastname: Al-Mufti
authors.forename: A A
authors.initials: AA
authors.lastname: Lewis
authors.forename: L A
authors.initials: LA
authors.lastname: Berger