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8/6/08

Oral milk-iodized solution before Virtual Colonscopy

Case submitted by: Dr. Giuseppe Francesco Davì,
Medical Radiologist
Department of Oncology of A.R.N.A.S.
Operative Unit of Vascular and Interventional Radiology Oncologic Hospital "M. Ascoli", Palermo (Italy)

Aim: Before Virtual Colonscopy (V.C.), promptly optimize a simple landmark and cleansing mucosa management. During V.C. locate, confirm pitfalls and differentiate these from a real pathological change of mucosal carpet.

History: Female 65 years old, with persistent pain in right flank and pelvic region. Family history of cancerous polyps.

Imaging findings
Panoramic view (Fig. 1): well distending colon and stomach.

Supine V.C. (Fig. 2):
Posterior milk-iodized lake

Prone V.C. (fig. 3):
Disappearance of all milk-iodized lakes. No flat or prominent real mucosal changes.

Supine V.C (fig. 4):
Too anteriorly doubtful small drops and milk-iodized lake.

Prone V.C. (fig. 5):
Good appearance of entire smooth and clean mucosal carpet. No lesions with statistically meaningful volume.

Conclusion:Some improvements in V.C. equipment and mucosal setting allow simple, easy and not-invasive boosts to avoid and eliminate pitfalls. This target may be decisive for diagnosis and next treatments. In our experience oral milk-iodized solution was too a quick aid well agree and with low cost.