Published online May 16, 2013. doi: 10.4253/wjge.v5.i5.226
Revised: March 5, 2013
Accepted: March 15, 2013
Published online: May 16, 2013
Processing time: 242 Days and 21.9 Hours
AIM: To describe colon anatomy with colonoscopy and computed tomography (CT) to develop a rat model for future studies of therapeutic colonoscopy.
METHODS: Eighteen male Sprague-Dawley rats, on average 400-420 g, underwent total colonoscopy, CT and histological examination. Colonoscopy was performed after bowel preparation with a baby upper gastrointestinal endoscopy with an outer diameter of 6.7 mm. CT obtained a 3D image of total colon after a rectal enema with radiological contrast. Macroscopic and microscopic examinations were examined with a conventional technique (hematoxylin and eosin). Colonic wall thickness, length and diameter measurements were taken from the anus, 3, 7, 14 and 20 cm from the anal margin.
RESULTS: The median colonoscope depth was 24 cm (range 20-28 cm). Endoscopic and tomographic study of colon morphology showed an easy access with tubular morphology in the entire left colon (proximal left colon and rectum). Transverse colon was unapparent on colonoscopy. Right colon, proximal to the splenic flexure, was the largest part of the colon and assumed saccular morphology with tangential trabecula. Radiological measurements of the colonic length and diameter substantiate a subdivision of the right colon into two parts, the cecum and distal right colon. In addition, histological measurement of the colonic wall thickness confirmed a progressive decrease from rectum to cecum. The muscular layer was thinner in the proximal left colon.
CONCLUSION: The combination of colonoscopy, tomography and histology leads to a better characterization of the entire colon. These data are important for deciding when to perform endoscopic resections or when to induce perforations to apply endoscopic treatments.
Core tip: There is a need for a solid colonoscopy animal model, complemented with digital radiology. Our subdivision of the rat colon constitutes a simplification of subdivisions presented by others who have emphasized the theoretical anatomical data. Our proposed subdivision of the colon is practical and justified by the importance of endoscopic access and the thickness of various portions of the colon wall. This study identified that the muscular layer was thinner in the proximal left colon. These findings are important for deciding when to perform endoscopic resections or when to induce perforations to apply endoscopic treatments.