Colonic distension prior to CT colonography entails gently administering gas (air or carbon dioxide) via a rectal catheter using either manual or automated insufflation techniques. Both gases and insufflation methods are widely used and all have their advocates; some favour the least expensive and simplest method, i.e. room air insufflation by manual compression of a plastic insufflator bulb, while others prefer carbon dioxide delivered by automated insufflation devices. Until recently, there has been a lack of objective evidence to recommend one method over another but there is now data emerging that will help to guide future practice (Burling et al. 2005; Rqgalla et al. 2004a,b; Yee et al. 2002).
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