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Contraindications include all conditions under which CT colonography could be harmful to the patient as well as situations in which it offers no diagnostic benefit. Among the contraindications for CT colonography are acute abdominal pain, nausea, vomiting, and diarrhea. CT colonography is also contraindicated in patients who have recently undergone laparotomy until the surgical wound has healed. It is also contraindicated after colon resection (recommended interval of approximately 3 months) and immediately after conventional colonoscopy with deep biopsy or polypectomy (recommended interval approximately 10 days). Other contraindications are hernias of the abdominal wall involving the colon; acute inflammatory bowel disease, such as acute diverticulitis or an acute episode of chronic inflammatory bowel disease; and previous total or subtotal colectomy. In such cases, distending the colon with gas could cause perforation and potentially subsequent peritonitis.
In certain situations, CT colonography is methodologically inappropriate. Examples include routine surveillance of chronic inflammatory bowel disease and evaluation of hereditary polyposis and nonpolyposis carcinoma syndromes, since follow-up of these patients requires biopsies.
Contraindications for CT colonography
Specific contraindications for CT colonography
Acute abdominal symptoms: acute pain, vomiting, diarrhea, acute abdomen
Less than 3 month (at least) after laparotomy or colon resection
After total or subtotal colectomy
Less than 10 days after polypectomy or deep biopsy
Abdominal hernias with complex colonic involvement
Acute inflammatory bowel disease:
General CT contraindications
CT colonography is unsuitable for:
Surveillance of patients with chronic inflammatory bowel disease
Hereditary polyposis and nonpolyposis carcinoma syndromes
Diseases of the anal canal
In addition, the same contraindications apply as for CT examinations in general: the weight and size restrictions of the examination table, metal implants that cause artifacts in the scan field, pregnancy, and claustrophobia (Table 1.2).
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