N. Maggialetti, R. Capasso, D. Pinto, M. Carbone, A. Laporta, S

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Diagnostic value of computed tomography colonography (CTC) after incomplete optical colonoscopy N. Maggialetti, R. Capasso, D. Pinto, M. Carbone, A. Laporta, S. Schipani, C.L. Piccolo, M. Zappia, A. Reginelli, M. D'Innocenzo, L. Brunese International Journal of Surgery Volume 33, Pages S36-S44 (September 2016) DOI: 10.1016/j.ijsu.2016.05.053 Copyright © 2016 Terms and Conditions

Fig. 1 Multimodality reconstruction of CTC in a patient with “neoplastic narrowing of sigmoid tract” observed during the incomplete OC examination. a/d: barium enema like/virtual endoscopy imaging. a: it is possible to observe the “apple core image” suggestive of neoplastic stenosis of the sigma; d: the same lesion in depicted in axial view and virtual endoscopy reconstruction modality. b: Axial image of normal colonic wall and its virtual endoscopy reconstruction. c: A polyp in the middle tract of sigma was identified, it was not found during previous OC examination which was stopped because of the neoplastic obstruction, but bowel stenosis represented not a limitation for CTC. The finding (polyp) is shown in axial and virtual endoscopy reconstruction views. International Journal of Surgery 2016 33, S36-S44DOI: (10.1016/j.ijsu.2016.05.053) Copyright © 2016 Terms and Conditions

Fig. 2 Imaging of significant extracolonic finding: the patient had a negative colonic examination (a). In axial images (b) a pathological enlargement of pancreatic body, suspicious for pancreatic cancer was observed. After integration with intravenous contrast medium administration (c) the diagnosis was confirmed. International Journal of Surgery 2016 33, S36-S44DOI: (10.1016/j.ijsu.2016.05.053) Copyright © 2016 Terms and Conditions

Fig. 3 Imaging of significant extracolonic findings. This patient was negative for any colonic findings (a) but was observed a pathological dilatation of the abdominal aorta. The examination was integrated by acquisition after intravenous contrast medium administration which revealed the presence of an abdominal aneurysm (b). The patient was treated with aortic endoprosthesis implantation (c). International Journal of Surgery 2016 33, S36-S44DOI: (10.1016/j.ijsu.2016.05.053) Copyright © 2016 Terms and Conditions

Fig. 4 This patient presented both a colonic length anomaly (“dolicosigma”) (a) and an extracolonic finding, an ovarian teratoma (b). International Journal of Surgery 2016 33, S36-S44DOI: (10.1016/j.ijsu.2016.05.053) Copyright © 2016 Terms and Conditions