The Examination

On the day of CT colonography the patients remain sober until the examination is performed. Whenever necessary we advise the patients to take their regular medication shortly before CT colonography. CT colonography is preferably performed in the morning. Prior to the exam the patient is instructed to visit the restroom to empty the rectum. Smooth muscle relaxation is achieved using scopolamine butylbromide (Buscopan®; Boehringer Ingelheim) (Taylor et al. 2003a). After distending the colon with CO2 using an automated inflator, the patients are scanned in supine and prone position using an ultra-low dose. Using a 64-slice scanner enables an ultra-low dose of 140 kV and 10 mAs without distortion of the image quality (Fig. 4.3).

If necessary, same day optical colonoscopy can be performed by preparing the patients with some additional laxatives after CT colonography (for instance 1 or 2 L of polyethylene glycol. Optical colonoscopy can be performed some 2 h after starting this additional prep (Lefere et al. 2002).

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Managing Diverticular Disease

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