Scintigraphic assessment of slow transit constipation with special reference to right- or left-sided colonic delay
2004 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 6, no 6, 499-505 p.Article in journal (Refereed) Published
OBJECTIVE: Subtotal colectomy and ileorectal anastomosis for slow transit constipation has several side-effects. The motor abnormality in some patients may be segmental which could motivate a limited resection of the colon. Therefore a diagnostic tool to identify a segmental colonic motor dysfunction is needed. The aim of this study was to evaluate a scintigraphic method to assess colonic transit with special reference to right- or left-sided delay. METHODS: Twenty-three constipated patients (19 women, mean age 50 years) with slow colonic transit on radio-opaque marker studies and 13 healthy individuals (11 women, mean age 46 years) were studied. All subjects were examined with oral (111)Indium-DTPA scintigraphy. The scintigraphic results for patients and controls were presented as geometric centre of radioactivity and percent activity over time in the right, the left and the recto-sigmoid colon. The inter-observer variation in the interpretation of the scans was also evaluated. RESULTS: There was no difference in transit time between the groups of patients and controls in the right colon whereas the patients had a significant delay in the left colon (P < 0.05). Two patients had a marked delay in the right colon followed by relatively rapid transit in the left colon. The inter-observer correlation was good comparing the right, the left and the recto-sigmoid colon (r = 0.58-0.98, P < 0.01-0.001). CONCLUSION: The results indicate that colonic scintigraphy with oral (111)Indium-DTPA may help to select patients for a left or, in a few cases, a right hemicolectomy for slow transit constipation.
Place, publisher, year, edition, pages
2004. Vol. 6, no 6, 499-505 p.
Adult, Aged, Case-Control Studies, Colon/physiology, Comparative Study, Constipation/physiopathology/*radionuclide imaging/surgery, Female, Gastrointestinal Transit/*physiology, History; Medieval, Humans, Indium Radioisotopes/*diagnostic use, Male, Manometry, Middle Aged, Observer Variation, Probability, Prospective Studies, Reference Values, Sensitivity and Specificity, Severity of Illness Index, Statistics; Nonparametric, Time Factors
IdentifiersURN: urn:nbn:se:uu:diva-92963DOI: 10.1111/j.1463-1318.2004.00694.xPubMedID: 15521943OAI: oai:DiVA.org:uu-92963DiVA: diva2:166298