Currently room air is used most frequently to manually insufflate the colon for CT colonography. Its ease of use and familiarity to radiologists and technologists because of a similar route of administration per rectum for double-contrast barium enema examinations have made it easily adaptable for CT colonography. It is also readily available at no additional cost. A large component of room air is nitrogen, which is inert, so that there is no active diffusion across the bowel wall when the colon is distended with air. Thus, following retrograde insufflation of the colon with room air, the colon will remain filled until the air is passed distally. Occasionally patients may experience severe pain and distension up to several hours after the CT colonography examination because of excess residual air within the colon. In an evaluation of symptom rates, 7% of subjects experienced significant pain and 13% had severe distension following air insufflation of the colon for barium enema (Skqvgaard et al. 1995).
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