Abstract
Common potential anorectal pitfalls are presented with accompanying CT colonography images. Although most lesions are benign, care must be taken in not missing an underlying cancer.
Highlights
It is highly likely that requests for computer tomographic colonography (CTC) will increase because it was very recently added to the colorectal cancer screening tests in the United States.[1]
A steep learning curve exists for CTC.[2]
The catheter may obscure pathology in some patients.[6]. To minimise this potential pitfall, it is important to deflate the balloon in the prone view: (1) to obtain a full scan series without an inflated balloon, to ensure good visualisation of the distal rectum, and (2) to better visualise internal haemorrhoids, if present.[6,9]
Summary
It is highly likely that requests for computer tomographic colonography (CTC) will increase because it was very recently added to the colorectal cancer screening tests in the United States.[1]. Based on the author’s experience, having performed > 6000 CTC examinations, the most common technical-related potential pitfalls (placement of the rectal catheter, stool and artefacts) and pathology-related pitfalls (internal haemorrhoids, polyps, cancer, hypertrophied anal papilla, perforation because of OC complications, and extrinsic impressions) are described with CTC images.[2,4,6,7,8] In female patients, it is essential to always check that the catheter is in the rectum and not in the vagina before commencing insufflation.[9]
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