Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Value of CT in the Discrimination of Fatal from Non-Fatal Stercoral Colitis

  • Wu, Cheng-Hsien (Division of Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University) ;
  • Huang, Chen-Chih (Division of Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University) ;
  • Wang, Li-Jen (Division of Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University) ;
  • Wong, Yon-Cheong (Division of Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University) ;
  • Wang, Chao-Jan (Division of Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University) ;
  • Lo, Wan-Chak (Division of Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University) ;
  • Lin, Being-Chuan (Division of Trauma and Emergency, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University) ;
  • Wan, Yung-Liang (Division of Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University) ;
  • Hsueh, Chuen (Department of Pathology, Chang Gung Memorial Hospital, Chang Gung University)
  • Published : 2012.06.01
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Abstract

Objective: Clinical presentation and physical signs may be unreliable in the diagnosis of stercoral colitis (SC). This study evaluates the value of computed tomography (CT) in distinguishing fatal from non-fatal SC. Materials and Methods: Ten patients diagnosed as SC were obtained from inter-specialist conferences. Additional 13 patients with suspected SC were identified via the Radiology Information System (RIS). These patients were divided into two groups; fatal and non-fatal SCs. Their CT images are reviewed by two board-certified radiologists blinded to the clinical data and radiographic reports. Results: SC occurred in older patients and displayed no gender predisposition. There was significant correlation between fatal SC and CT findings of dense mucosa (p = 0.017), perfusion defects (p = 0.026), ascites (p = 0.023), or abnormal gas (p = 0.033). The sensitivity, specificity, and accuracy of dense mucosa were 71%, 86%, and 81%, respectively. These figures were 75%, 79%, and 77% for perfusion defects; 75%, 80%, and 78% for ascites; and 50%, 93%, and 78% for abnormal gas, respectively. Each CT sign of mucosal sloughing and pericolonic abscess displayed high specificity of 100% and 93% for diagnosing fatal SC, respectively. However, this did not reach statistical significance in diagnosing fatal SC. Conclusion: CT appears to be valuable in discriminating fatal from non-fatal SC.

Keywords

References

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