Colon anatomy based on CT colonography and fluoroscopy: Impact on looping, straightening, and ancillary maneuvers in colonoscopy

Aims: Unsedated colonoscopy is an uncomfortable procedure for most patients. Discomfort during colonoscopy is largely related to looping of the colonoscope, which displaces the colon from its native configuration and stretches attachments to the mesentery. Therefore, complete intubation of the colon is considerably difficult in up to 10–20% of procedure. Reasons for failure of complete colonocopy are multifactorial. Aims of this study were (1) to determine the „normal“ colon anatomy in CT-colonoscopy with special focus on length, number of flexures and tortuosity and (2) to assess frequency and type of looping a…