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:

    • Acute episode of inflammatory bowel disease

    • Toxic megacolon

    • Acute diverticulitis

    • Acute infectious colitis

General CT contraindications

  • Pregnancy

  • Morbid obesity

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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Jun 26, 2020 | Posted by in GASTROENTEROLOGY | Comments Off on Contraindications
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