Adverse events of computed tomography colonography: an Italian National Survey.

AIM: To retrospectively study the frequency and magnitude of complications associated with computed tomography (CT) colonography in clinical practice. METHODS: A questionnaire on complications of CT colonography was sent to Italian public radiology departments identified as practicing CT colonography with a reasonable level of training. The frequency of complications and possible risk factors were retrospectively determined. Responses were collated and row frequencies determined. A multivariate analysis of the factors causing adverse events was also performed. RESULTS: 40,121 examinations were performed in13 centers during the study period. No deaths were reported. Bowel perforations occurred in 0.02% (7 exams). All perforations were asymptomatic and occurred in patients undergoing manual insufflation. Five perforations (71%) occurred in procedures performed following a recent colonoscopy. There was no significant difference between perforations associated with rectal balloon (0.017%) and those that were not (0.02%). Complications related to vasovagal reaction (either with or without spasmolytic) occurred in 0.16% (63 exams). All vasovagal reactions resolved in less than 3h, without any sequelae. CONCLUSIONS: Perforation rate at CT colonography in Italy is comparable with elsewhere in the world, occurring regardless of the experience of radiology centers. Although the risk is very small, it may not be negligible when compared with the risk of diagnostic colonoscopy.

[Current understanding of the role of virtual colonoscopy in abdominal diagnosis]. / Attuali conoscenze sul ruolo della colonscopia virtuale nella diagnostica addominale.

Virtual colonoscopy is a non invasive technique allowing to study the colon from the inside, as conventional colonoscopy, without introducing an endoscope. Virtual colonoscopy is able to study the entire colon and its pathologies, allowing an early detection of its pathology without risks or contraindication. Virtual colonoscopy is an accurate, risk free and well tolerated technique now officially considered a valid option in colorectal cancer screening. Nowadays the well recognized indication of CT colonography examination are: for the prevention of colon-rectum cancer (screening), for all the individuals at average risk, men and women over 50 years old, as reported by colorectal cancer screening guidelines, published in march 2008 by the American Cancer Society. For diagnosis: for all the patients with intestinal disorder for whom a radiological or endoscopical study of the colon is required, to complete a conventional endoscopy in those patients where conventional examination is incomplete for several reason; and in those elderly patients with some contraindication for conventional examination.