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This study was done to determine colonic transit times in healthy Italian adults. Institutional review board approval and informed patient consent were obtained. Colonic segmental radiopaque markers were counted and transit times calculated in 36 healthy subjects studied using a technique involving daily radiopaque marker ingestion and single radiological visit, with oral administration of 8–10 ml of a thick barium paste as a colonic trace for the marker count. Two independent radiologists counted the marker twice. Observer agreement was assessed using comparison analysis. There was very good observer agreement for the segmental marker counts. The upper limit for colonic transit times was: 45.6 h in the colon as a whole, 31.2 h in the right colon, 19.2 h in the left colon and 16.8 h in the rectosigmoid. Colonic transit times were not gender-related. In healthy subjects, a barium trace affords optimal visibility of the different colonic segments, enabling accurate location of all markers and thus providing an anatomy-related, repeatable and reproducible fluoroscopic segmental marker count. We suggest that the reference values for normal colonic transit times could be adopted for Italian people irrespective of gender.

In spite of the improved imaging techniques currently available, mortality for pancreatic cancer is still high, and pancreatitis is often diagnosed only in its advanced stages. The authors investigated the value of different imaging techniques--i.e., US, CT, and ERCP--for an early diagnosis, when a more effective (curative?) treatment can be suggested. Fifty-six cases of pancreatic cancer and 36 cases of chronic pancreatitis were evaluated. The results indicate that ERCP, with the help of statistical methods, is superior to US and CT not only in evaluating early neoplastic or inflammatory lesions, but also for their differential diagnosis. In the latter case, ERCP can sometimes be used as a valid alternative to fine-needle aspiration biopsy.

Fifty-three patients were examined by endoscopic retrograde cholangiopancreatography (ERCP). Operative and/or instrumental-clinical findings indicated that 38 patients had pancreatic disease, consisting of 17 cases of neoplasia, 10 of chronic pancreatitis with benign stenosis, and 11 of chronic pancreatitis without stenosis. An analysis of Wirsung's duct and of the secondary ducts was carried out employing, in the latter case, linear discriminate analysis (Nix and Schmitz method). With this method, 16 of 17 patients (94%) were correctly assigned to group A (pancreatic neoplasia), thus indicating high sensitivity; 7 of 8 patients (88%) were assigned to group B (chronic pancreatitis with benign stenosis), and finally 7 of 10 patients (70%) were placed in group C (chronic pancreatitis without stenosis). Detection of a sample sign such as sharp and/or irregular stenosis of Wirsung's duct enabled a correct diagnosis of neoplasia in the cases examined; this criterion, however, is very specific but poorly sensitive. When it is absent, analysis of the secondary ducts is determinant. If the two criteria are applied together, an exact diagnosis of all forms of neoplasia is obtained.

The authors present 3 cases of duodeno-colic involvement by malignant neoplasms and analyse the main radiological features. Benign and malignant duodenocolic fistulas are discussed and colic lesions caused by an extrinsic process. Guiding radioanatomical criteria are stated namely the alterations in the site of the principal lesion first and, afterwards, the morphological changes or displacement of the bowel.