Value of CT in the Discrimination of Fatal from Non-Fatal Stercoral Colitis.
10.3348/kjr.2012.13.3.283
- Author:
Cheng Hsien WU
1
;
Chen Chih HUANG
;
Li Jen WANG
;
Yon Cheong WONG
;
Chao Jan WANG
;
Wan Chak LO
;
Being Chuan LIN
;
Yung Liang WAN
;
Chuen HSUEH
Author Information
1. Division of Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan. ycwong@adm.cgmh.org.tw
- Publication Type:Original Article
- Keywords:
Fecaloma;
Stercoral colitis;
Computed tomography;
Fatality
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Chi-Square Distribution;
Colitis/mortality/*radiography;
Contrast Media/diagnostic use;
Diagnosis, Differential;
Fecal Impaction/mortality/*radiography;
Female;
Humans;
Male;
Middle Aged;
Retrospective Studies;
Risk Factors;
Sensitivity and Specificity;
Statistics, Nonparametric;
Tomography, X-Ray Computed/*methods
- From:Korean Journal of Radiology
2012;13(3):283-289
- CountryRepublic of Korea
- Language:English
-
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.
