The Role of Multislice Computed Tomography of the Colon in the Diagnostic Algorithm of Chronic Constipation

The purpose: approbation of the method of multislice computed tomography colonography in the diagnosis of chronic colostasis. Materials and methods. Multislice computed tomography colonography, using the Philips Brilliance 64 (collimation 1,5 mm; 120 kV; 50 mAs, total duration of procedure - 18 seconds, equivalent dose-14 mSv), had been evaluated during clinical examination of 26 patients with decompensated forms of chronic constipation. Results. We have received encouraging results from a pilot study of multislice computed tomography colonography, allowing to obtain three-dimensional volumetric image of the colon with abnormal architectonics and unusual location in the abdominal cavity were noted. Method objectively reflects the characteristics of colonic structure, the anatomical and topographical relationships of its various parts, degenerative changes in the wall, the localization of stasis of intestinal contents and allows us to visualize the rare forms of colonic anomalies, due to the peculiarities of the colonic structure and the anatomic-topographic changes in the pelvic cavity. Diagnosis of pathological mobility of the gut by this method is difficult and requires additional clarification by other radiological methods. Conclusions. Multislice computed tomography colonography is a promising method of study the large intestine. It expands the range of diagnostic methods of chronic constipation and allows making a differentiated choice of proper type of treatment. The method can be considered as an alternative to the barium enema - the traditional diagnostic method of congenital and acquired anomalies of structure and position of the colon in the abdominal cavity.

хронический запор, мультиспиральная компьютерно-томографическая колонография, апробация метода, chronic constipation, multislice computed tomography colonography, approbation of the method

1. Stark M.E. Challenging problems presenting as constipation. Am. J. Gastroenterol. 1999; 94: 567-574.

2. Wexner S.D., Stollman N. Diseases of the colon. New-York: Informa Healthcare, 1990. 809 p.

3. Ачкасов С.И. Аномалии развития и положения толстой кишки: клиника, диагностика, лечение. Автореф. дис. … д-ра мед. наук. М., 2003. 32 c.

4. Джавадов Э.А. Хирургическое лечение больных с хроническим колостазом на фоне долихоколон: Автореф. дис. … д-ра мед. наук. М., 2011. 32 c.

5. Смоленцева Н.В., Голимбиевская Т.А., Дементьева Т.В. Возможности компьютерно-томографической колонографии в диагностике заболеваний толстой кишки: Материалы науч.-практ. конф., посвящ. 10-летию МЦ ФГУП “Адмиралтейские Верфи”: СПб., 2005. 22 c.

6. Philip A.K., Lubner M.G., Harms B. Computed tomographic colonography. Surg. Clin. N. Am. 2011; 91: 127-139.

7. Саидов Ф.Х., Хусанходжаев Ж.У. Мультисрезовая компьютерная томография в диагностике хронического колостаза у детей. Радиология-Практика. 2014; 4 (46): 30-38.

8. Хавкин А.И. Функциональные нарушения желудочно-кишечного тракта у детей раннего возраста. Пособие для врачей: М.: Медицина, 2000. 72 c.

9. Ингерлейб М.Б. Полный медицинский справочник анализов и исследований в медицине. М.: Омега-Л. Книжный Дом, 2014. 300 c.

10. Рабухина Н.А. Первичное двойное контрастирование желудочно-кишечного тракта. М.: Медицина, 1985. 127 c.