The Importance of CT Pneumocolon in Detecting Colonic Lesions

Background: Colonic masses are clinically important because some of them are malignant and others have a tendency to become malignant such as polyps. CT pneumocolon may have a role in the evaluation and diagnosis of these masses. Objective: To determine the accuracy of computed tomography (CT) pmeumocolon in the detection of colonic masses compared with colonoscopy. Patients and Methods: A total of 60 patients with colorectal symptoms underwent evaluation for the presence of colorectal neoplasms by using both colonoscopy and CT pneumocolon and a comparison was made between them. Results: On colonoscopy, 10 out of 60 patients were having a negative colonoscopy. The results of colonoscopy of the other 50 patients were as follow; three out of fifty colonoscopies revealed invasive colorectal carcinomas in threse patients. The remaining 47 colonoscopies for 47 patients revealed benign polyps. The sizes of these polyps were as follows; (6 polyps were ˃1 cm in diameter), (17 polyps were 6-9 mm), and (24 polyps were ≤5 mm). CT pneumocolon detected all 3 malignant masses seen and biopsied by colonoscopy, but only (28 single polyps) which according to their size (4 polyps were ≥ 1cm), (11 polyps were 6-9 mm) and (13 polyps ≤5 mm), this gives CT pneumocolon a sensitivity of (63%), specificity of (70%) and accuracy (63%). Conclusion: CT pneumocolon has high sensitivity and specificity for a detection of large-sized masses, but not for small ones. CT pneumocolon may be suitable for investigating patients with symptomatic colorectal masses noninvasively. Keywords: Pneumocolon, colonoscopy, polyp, colonic carcinoma