Improving Diagnosis

Despite an intensive cleansing of the colon using regular preparations without faecal tagging, both residual stool and fluid in the colon not infrequently cause diagnostic difficulties (Johnson and Dachman 2000) (see also Chap. 8). Residual stool may appear isodense to the colonic wall and cause pseudopolypoid images, mimicking lesions and possibly resulting in false positive findings (FeNloN 2002; MAcAri and Megibow 2001a). Residual fluid is also isodense to the colonic wall and tumoral lesions. Hence, when present in a large amount, some parts of the colon can be obscured in both supine and prone position, resulting in incomplete visualization of the colonic wall. This may of course result in false negative findings. Occasionally, a polyp mimics residual stool and even fluid, possibly resulting in false negative findings. By labelling both residual stool and fluid in the colon with positive contrast material, both these false positives and negatives could be avoided and consequently facilitate and improve diagnosis (Fig. 4.1) (see also imaging findings).

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