Objective: To prospectively evaluate and complete the colonic distention and patient acceptance of CT colonography (CTC) in the supine/prone and left/right lateral positions.
Methods: A total of 220 consecutive patients were alternately allocated to the supine/prone positioning or left/right lateral positioning group. Two readers scored the degree of colonic distention by segment using a 4-point Likert scale (4 = optimal, 3 = adequate, 2 = inadequate, 1 = collapsed). In addition, patients were asked to rate the discomfort due to positioning during each scan using a 3-point animated face scale (3 = difficult, 2 = somewhat unacceptable, 1 = easy).
Results: The overall mean colonic distention scores for supine, prone, left lateral, and right lateral positions were 3.16, 3.29, 3.22, and 3.42, respectively. Of all, the right lateral position provided the best colonic distention ( < 0.01). Combined left lateral and right lateral positions provided more adequately distended segments compared with combined supine and prone positions (95.6% 90.7 %, respectively, < 0.01). Patient acceptance was significantly lower in the prone position compared to other positions; however there was no difference in patient acceptance between the supine and left/right lateral positions.
Conclusion: Right lateral positioning provided the best colonic distention and good patient acceptance.
Advances In Knowledge: The left/right lateral position should be considered for routine CTC positioning protocols.
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http://dx.doi.org/10.1259/bjr.20180538 | DOI Listing |
Cureus
November 2024
Department of General Surgery, Western General Hospital, Edinburgh, GBR.
This systematic review explores the association between herpes zoster (HZ) infection and Ogilvie's syndrome (acute colonic pseudo-obstruction), evaluating how varicella-zoster virus (VZV) reactivation may contribute to autonomic dysfunction leading to intestinal obstruction. A comprehensive search was conducted in PubMed, Scopus, and Cochrane Library databases up to October 2024, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies included case reports, clinical images, and letters reporting Ogilvie's syndrome secondary to HZ or VZV infection.
View Article and Find Full Text PDFCureus
November 2024
Department of Intensive Care Medicine, Centro Hospitalar Universitário de São João, Porto, PRT.
A 73-year-old man presented with nausea, abdominal discomfort, and distention persisting for the past five days. He had previously been diagnosed with stage III peripheral CD4+ T cell lymphoma and had initiated chemotherapy comprising vincristine two weeks prior to presentation. An evaluation revealed diffuse colon distention and pneumatosis intestinalis without mechanical obstruction, consistent with acute colonic pseudo-obstruction.
View Article and Find Full Text PDFCase Rep Gastrointest Med
December 2024
Department of Cardiology, Medical College of Georgia, Augusta University, Augusta, Georgia, USA.
Acute colonic pseudo-obstruction (ACPO), or Ogilvie syndrome, is a rare condition marked by significant colon distention without mechanical obstruction. Symptoms include abdominal pain, bloating, nausea, vomiting, and an inability to pass gas or stool. Although common in males over 60, we report a challenging case of a 44-year-old man from Africa with recurrent abdominal distention and discomfort.
View Article and Find Full Text PDFInt J Surg Case Rep
December 2024
Department of Visceral and Digestive Surgery, Monastir University Hospital, Monastir, Tunisia.
Introduction And Importance: This case report aims to highlight the clinical presentation, diagnostic challenges, surgical intervention, and subsequent management strategies of ISK during Ramadan fasting.
Case Presentation: 52-Year-old male with a three-day history of symptoms of intestinal obstruction. He complained of abdominal distention, vomiting, and absolute constipation.
Surg Case Rep
November 2024
Department of Surgery, Fuji General Hospital, Shizuoka, Japan.
Background: The majority of colorectal malignancies are primary tumors. Secondary tumors are rare, and colorectal metastasis from endometrial carcinoma is exceptionally uncommon. We report a case of serous endometrial carcinoma that metastasized to the sigmoid colon, initially presenting as a primary colon carcinoma due to bowel obstruction.
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