Patient's Query
Hello doctor,
I recently underwent a CT scan with intravenous contrast, which revealed cecum enlargement. Following this, the radiologist recommended a follow-up scan with oral contrast only. This second scan, conducted a few hours later in the ER, showed normal results. For context, I have a history of chronic constipation, hemorrhoids, and narrow, small-sized stools. I am currently taking Paxil, Buspar, vitamin D, and Miralax. Recent lab tests, including CBC, CMP, and lipase, all returned normal. Could you please review the reports and provide your insights? Please help.
Thank you.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
The cecum, a part of the large intestine, can become distended for various reasons, including chronic constipation.
A distended cecum is observed on an intravenous (IV) contrast computed tomography (CT) scan (attachments removed to protect the patient's identity) but appears normal on an oral contrast CT scan (attachments removed to protect the patient's identity). This might be due to fluid accumulation, differences in contrast, highlighting vascular or wall abnormalities, or a transient functional obstruction. These factors can make conditions like inflammation, masses, or anatomical variations more apparent with IV contrast. While stool burden is a common cause of distension, other factors can also contribute.
I suggest managing constipation (hardening of stools causing pain) regularly can help alleviate symptoms and potentially ease related issues such as hemorrhoids (swollen veins in the lower part of the rectum and anus).
I hope this helps.
Please revert so I can assist you further.
Thank you.
Patient's Query
Hi doctor,
Thank you for your reply.
Should the second scan with oral contrast be considered the final diagnosis? Would a mass still have been visible with the oral contrast? I also have a gastrointestinal consult scheduled. Please help.
Thank you.
Hi,
Welcome back to icliniq.com.
I read your query and can understand your concern.
The second CT (computerized tomography) scan with oral contrast provides valuable diagnostic information and should be considered for a more accurate assessment. Consulting with a gastroenterologist is advisable to address your constipation, as effective management can significantly improve digestive health and potentially prevent further complications.
I hope this helps.
Please revert in case of further queries.
Thank you.
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Answered byDr. Muhammed Hassan
Medically reviewed byiCliniq medical review team
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