Extracolonic findings at computed tomography colonography are a challenge

Pedersen, B. Ginnerup; Resenkilde, M.; Christiansen, T. E. M.; Laurberg, S.
December 2003
Gut;Dec2003, Vol. 52 Issue 12, p1744
Academic Journal
Aim: Our aim was to perform a prospective evaluation of the frequency and diagnostic consequences of extracolonic findings at multidetector array computed tomography colonography (MDCTC) in asymptomatic patients undergoing surveillance for former colorectal polyps or cancer. Patients and methods: Seventy five consecutive patients undergoing surveillance for former colorectal cancer (CRC) or large bowel adenoma were examined with MDCC. Two independent observers evaluated the images with regard to extracolonic findings. Patient records and radiological information systems were reviewed to determine the results and consequences of the workup derived from MDCC. Results: Sixty five per cent (95% confidence interval (CI) 55-73%) of patients had extracolonic abnormalities and in 12% (CI 7-18%) of patients additional workup was indicated. Two patients (3% (CI 1-6%)) underwent surgery because of the findings (one) or because of complications of the workup (one). Conclusion: MDCC identifies a large number of extracolonic findings. Approximately 12% of asymptomatic patients undergo additional workup, of benefit to only a few. The high prevalence of extracolonic findings may make MDCC a problematic colorectal screening tool for both ethical and economic reasons.


Related Articles

  • Endoscopic polypectomy: outcomes of 467 cases in 20 years. Atamanalp, S. Selçuk; Şentürk, Fuat; Gürsan, Nesrin; Öztürk, Gürkan; Kantarci, Mecit; Yildirgan, M.İlhan; Başoğlu, Mahmut // Turkish Journal of Medical Sciences;2009, Vol. 39 Issue 5, p747 

    Aim: Endoscopic polypectomy has an important place in the treatment of polyps-the preliminary lesions of colorectal cancers. This study aimed to discuss the outcomes of endoscopic polypectomy in 467 patients for 692 polyps over the course of 20 years. Materials and methods: The records of 692...

  • SIGNIFICANCE OF RECTOSIGMOID ADENOMAS. Kramar, Jane; French, Linda // Journal of Family Practice;Apr1997, Vol. 44 Issue 4, p339 

    The article presents a study which investigated the importance of rectosigmoid adenomas detected by sigmoidoscopy. The increased detection of tiny adenomatous polyps in asymptomatic patients was due to the increased use of flexible sigmoidoscopy as a screening examination for colorectal...

  • APC Gene in Familial Adenomatous Polyposis. Fodde, Riccardo // Encyclopedic Reference of Cancer;2001, p68 

    A definition of the term "APC gene in familial adenomatous polyposis" is presented, which refers to familial adenomatous polyposis, which is a dominant condition predisposing to the development of multiple colorectal adenomas, that is polyps, during adolescence. Adenomatous polyps are benign...

  • Histopathological and Clinical Evaluation of Serrated Adenomas of the Colon and Rectum. Bariol, Carolyn; Hawkins, Nicholas J.; Turner, Jennifer J.; Meagher, Alan P.; Williams, David B.; Ward, Robyn L. // Modern Pathology;May2003, Vol. 16 Issue 5, p417 

    We evaluated the diagnostic utility of the histological characteristics ascribed in the literature to serrated adenomas and developed a practical working model to allow their reliable identification. We also documented the frequency and location of serrated adenomas identified in an unselected...

  • Screening colonoscopy in 40- to 50-year-old first-degree relatives of patients with colorectal cancer is efficient: a controlled multicentre study. Menges, Markus; Fischinger, Johannes; Gärtner, Barbara; Georg, Thomas; Woerdehoff, Dietrich; Maier, Matthias; Harloff, Matthias; Stegmaier, Christa; Raedle, Jochen; Zeitz, Martin // International Journal of Colorectal Disease;Jul2006, Vol. 21 Issue 4, p301 

    Explores the adenoma prevalence in 40- to 50-year old first-degree relatives of colorectal cancer patients. Steps taken by researchers to inform patients and their relatives about the study; Prevalence of persons with polyps; Data on the distribution of polyps according to gender.

  • Phenotypic diversity in patients with multiple serrated polyps: a genetics clinic study. Buchanan, Daniel D.; Sweet, Kevin; Drini, Musa; Jenkins, Mark A.; Win, Aung Ko; Gattas, Michael; Walsh, Michael D.; Clendenning, Mark; McKeone, Diane; Walters, Rhiannon; Roberts, Aedan; Young, Alasdair; Hampel, Heather; Hopper, John L.; Goldblatt, Jack; George, Jill; Suthers, Graeme K.; Phillips, Kerry; Young, Graeme P.; Chow, Elizabeth // International Journal of Colorectal Disease;Jun2010, Vol. 25 Issue 6, p703 

    Hyperplastic polyposis is a colonic polyposis condition of unknown aetiology. The purpose of this study was to examine the spectrum of phenotypic variation in patients with multiple serrated polyps as a basis for gene discovery. One hundred and twenty-six patients with multiple (≥5)...

  • Synchronous polyps in patients with colorectal cancer. Demetriades, H.; Kanellos, I.; Blouhos, K.; Tsachalis, T.; Vasiliadis, K.; Pramateftakis, M.; Betsis, D. // Techniques in Coloproctology;Nov2004 Supplement 1, Vol. 8, ps72 

    Background The aim of this study is to underscore the incidence of synchronous polyps in patients with colorectal cancer and to emphasise the importance of their perioperative detection and management. Patients and methods Three hundred and seven patients underwent a potentially curative...

  • Metachronous Colon Cancer in Persons Who Have Had a Large Adenomatous Polyp. Otchy, Daniel P.; Ransohoff, David F.; Wolff, Bruce G.; Weaver, Amy; Ilstrup, Duane; Carlson, Harley; Kademacher, Diana // American Journal of Gastroenterology;Mar1996, Vol. 91 Issue 3, p448 

    Objective: To determine, among persons who have had a large colon polyp, the risk of subsequent colon cancer at a site distant from that polyp. Methods: Follow-up was done for 226 persons at the Mayo Clinic who had had a ≥1-cm polyp demonstrated on barium enema between 1965 and 1970 and...

  • Cronkhite-Canada syndrome with adenomatous polyposis. Y., Radha Krishna; U. C., Ghoshal; N., Kumari; R., Pandey; G., Choudhuri // Journal of Postgraduate Medicine;Apr-Jun2008, Vol. 54 Issue 2, p144 

    The article features the Cronkhite-Canada syndrome (CCS) with adenomatous polyposis. CCS is an acquired polyposis syndrome that features hamartomatous polyps similar to those of juvenile polyps and epidermal changes. There were about 400 patients in the English medical literature being reported...


Read the Article


Sign out of this library

Other Topics