Korean Journal of Radiology

  • 제13권3호
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  • Pages.283-289
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  • 2012
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지
DOI QR코드

DOI QR Code

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)
  • 발행 : 2012.06.01
⟨ 이전 논문 다음 논문 ⟩

초록

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.

키워드

참고문헌

  1. Yano T, Wakabayashi H, Yachida S, Okano K, Izuishi K, Suzuki Y. A stercoral perforation of the colon with an obvious faecal mass diagnosed by computed tomography. ANZ J Surg 2008;78:214-215 https://doi.org/10.1111/j.1445-2197.2007.04411.x
  2. Wald A. Management and prevention of fecal impaction. Curr Gastroenterol Rep 2008;10:499-501 https://doi.org/10.1007/s11894-008-0091-y
  3. Sharma M, Agrawal A. Case report: Stercoral sigmoid colonic perforation with fecal peritonitis. Indian J Radiol Imaging 2010;20:126-128 https://doi.org/10.4103/0971-3026.63051
  4. Zissin R, Hertz M, Osadchy A, Even-Sapir E, Gayer G. Abdominal CT findings in nontraumatic colorectal perforation. Eur J Radiol 2008;65:125-132 https://doi.org/10.1016/j.ejrad.2007.03.014
  5. Serpell JW, Nicholls RJ. Stercoral perforation of the colon. Br J Surg 1990;77:1325-1329 https://doi.org/10.1002/bjs.1800771204
  6. Haddad R, Bursle G, Piper B. Stercoral perforation of the sigmoid colon. ANZ J Surg 2005;75:244-246 https://doi.org/10.1111/j.1445-2197.2005.03337.x
  7. Wu CH, Wang LJ, Wong YC, Huang CC, Chen CC, Wang CJ, et al. Necrotic stercoral colitis: importance of computed tomography findings. World J Gastroenterol 2011;17:379-384 https://doi.org/10.3748/wjg.v17.i3.379
  8. Ouaïssi M, Sielezneff I, Benoist S, Pirro N, Cretel E, Chaix JB, et al. Lethal fecaloma. J Am Geriatr Soc 2007;55:965-967 https://doi.org/10.1111/j.1532-5415.2007.01191.x
  9. Rozenblit AM, Cohen-Schwartz D, Wolf EL, Foxx MJ, Brenner S. Case reports. Stercoral perforation of the sigmoid colon: computed tomography findings. Clin Radiol 2000;55:727-729 https://doi.org/10.1053/crad.1999.0173
  10. Maurer CA, Renzulli P, Mazzucchelli L, Egger B, Seiler CA, Büchler MW. Use of accurate diagnostic criteria may increase incidence of stercoral perforation of the colon. Dis Colon Rectum 2000;43:991-998 https://doi.org/10.1007/BF02237366
  11. Heffernan C, Pachter HL, Megibow AJ, Macari M. Stercoral colitis leading to fatal peritonitis: CT findings. AJR Am J Roentgenol 2005;184:1189-1193 https://doi.org/10.2214/ajr.184.4.01841189
  12. Kim MJ, Park SH, Lee SS, Byeon JS, Choi EK, Kim JH, et al. Efficacy of barium-based fecal tagging for CT colonography: a comparison between the use of high and low density barium suspensions in a Korean population - a preliminary study. Korean J Radiol 2009;10:25-33 https://doi.org/10.3348/kjr.2009.10.1.25
  13. Frager DH, Baer JW. Role of CT in evaluating patients with small-bowel obstruction. Semin Ultrasound CT MR 1995;16:127-140 https://doi.org/10.1016/0887-2171(95)90005-5
  14. Furukawa A, Kanasaki S, Kono N, Wakamiya M, Tanaka T, Takahashi M, et al. CT diagnosis of acute mesenteric ischemia from various causes. AJR Am J Roentgenol 2009;192:408-416 https://doi.org/10.2214/AJR.08.1138
  15. Boudiaf M, Soyer P, Terem C, Pelage JP, Maissiat E, Rymer R. Ct evaluation of small bowel obstruction. Radiographics 2001;21:613-624 https://doi.org/10.1148/radiographics.21.3.g01ma03613
  16. Rha SE, Ha HK, Lee SH, Kim JH, Kim JK, Kim JH, et al. CT and MR imaging findings of bowel ischemia from various primary causes. Radiographics 2000;20:29-42 https://doi.org/10.1148/radiographics.20.1.g00ja0629
  17. Lohrmann C, Ghanem N, Pache G, Makowiec F, Kotter E, Langer M. CT in acute perforated sigmoid diverticulitis. Eur J Radiol 2005;56:78-83 https://doi.org/10.1016/j.ejrad.2005.03.003
  18. Miki T, Ogata S, Uto M, Nakazono T, Urata M, Ishibe R, et al. Multidetector-row CT findings of colonic perforation: direct visualization of ruptured colonic wall. Abdom Imaging 2004;29:658-662 https://doi.org/10.1007/s00261-003-0159-y
  19. Kim SW, Shin HC, Kim IY, Kim YT, Kim CJ. CT findings of colonic complications associated with colon cancer. Korean J Radiol 2010;11:211-221 https://doi.org/10.3348/kjr.2010.11.2.211
  20. Rubesin SE, Levine MS. Radiologic diagnosis of gastrointestinal perforation. Radiol Clin North Am 2003;41:1095-115, v https://doi.org/10.1016/S0033-8389(03)00100-3
  21. Yeung KW, Chang MS, Hsiao CP, Huang JF. CT evaluation of gastrointestinal tract perforation. Clin Imaging 2004;28:329- 333 https://doi.org/10.1016/S0899-7071(03)00204-3
  22. Hainaux B, Agneessens E, Bertinotti R, De Maertelaer V, Rubesova E, Capelluto E, et al. Accuracy of MDCT in predicting site of gastrointestinal tract perforation. AJR Am J Roentgenol 2006;187:1179-1183 https://doi.org/10.2214/AJR.05.1179
  23. Maniatis V, Chryssikopoulos H, Roussakis A, Kalamara C, Kavadias S, Papadopoulos A, et al. Perforation of the alimentary tract: evaluation with computed tomography. Abdom Imaging 2000;25:373-379 https://doi.org/10.1007/s002610000022
  24. Yoo HJ, Kim SH, Lee JM, Kim MA, Han JK, Choi BI. The association of anisakiasis in the ascending colon with sigmoid colon cancer: CT colonography findings. Korean J Radiol 2008;9 Suppl:S56-S60 https://doi.org/10.3348/kjr.2008.9.s.s56
  25. Sood BP, Rezai S, Parker D. Unusual radiological appearance of a faecaloma. Australas Radiol 2007;51 Spec No:B161-B164 https://doi.org/10.1111/j.1440-1673.2007.01695.x
  26. Huang WS, Wang CS, Hsieh CC, Lin PY, Chin CC, Wang JY. Management of patients with stercoral perforation of the sigmoid colon: report of five cases. World J Gastroenterol 2006;12:500-503 https://doi.org/10.3748/wjg.v12.i3.500
  27. Patel VG, Kalakuntla V, Fortson JK, Weaver WL, Joel MD, Hammami A. Stercoral perforation of the sigmoid colon: report of a rare case and its possible association with nonsteroidal anti-inflammatory drugs. Am Surg 2002;68:62-64
  28. Chen JH, Shen WC. Rectal carcinoma with stercoral ulcer perforation. Hepatogastroenterology 2000;47:1018-1019

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  11. A case of colonic obstruction combined with ischemic colitis vol.4, pp.1, 2012, https://doi.org/10.1002/agm2.12145
  12. Stercoral colitis due to massive fecal impaction: a case report and literature review vol.16, pp.8, 2021, https://doi.org/10.1016/j.radcr.2021.04.067