Background: ileocolonic thickeningis a commonly reported finding on diagnostic abdominal pelvic computed tomography (CT) in patients with history of lower gastrointestinal symptoms. The significance of this nonspecific finding is not clear.
Aim: To establish clinicopathological diagnosis in ileocolonic thickening on CT.
Methods: To identify whether colonic wall thickening identified at CT consistently warrants colonoscopy, consecutive colonoscopies performed at tertiary care centre in southern India from November 2016 to January 2018.Clinical, radiologic, Colonoscopic, and histologic data were obtained from medical records.
Results: A total of 90 patients met the inclusion criteria of our study. Of those, 88% had various identifiable pathologies on colonoscopy. Only 12% had normal colonoscopic findings. CT Abdomen prior to colonoscopy shows following diagnosis: tumor (n = 21, 27.6%), ischemic colitis (n = 15, 19.7%), diverticulitis (n = 2, 0.02%), tuberculosis (TB) (n = 10, 13.1%).After colonoscopy and biopsy, no abnormality detected in (12%, n = 9), adenocarcinoma (15.6%, n = 12), adenoma (6%, n = 4), ulcerative colitis (9%, n = 6), nonspecific colitis (32.4%, n = 24), Crohn’s disease (5.3%, n = 3), and hyperplastic polyp (3%,n = 2), Ischemic colitis(6.5%,n=5), radiation-induced colitis (10%,n=7) infective colitis and TB (8%,n=9)Inflammatory bowel disease (IBD), adenocarcinoma of colon and infectious colitis were the most common causes of ileocolonic thickening.
Conclusion: we recommend that patients who are symptomatic and are found to have BWT on CT should undergo evaluation with colonoscopy to determine the underlying cause and help better direct patient care.The combination of CT and colonoscopy results in greater accuracy.
Impact Factor
2022: 6.012
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