title: Clinical significance of incidental colorectal wall thickening on computed tomography scan in African-American and Hispanic patients.
abstract: We sought to assess the significance of an incidental finding of colorectal wall thickening (CRWT) on computed tomography (CT) scan in African-American and Hispanic patients. We retrospectively reviewed charts of African-American and Hispanic patients from January 1994 to December 2005. Those patients were included in whom the colonoscopy was performed due to incidental CRWT on CT scan. Patients with a history or a family history of colorectal malignancy, inflammatory bowel disease, or colorectal surgery, with an incomplete colonoscopic examination, or <18 years of age were excluded. Endoscopic and pathological findings were abstracted. Thirty-two patients met the criteria. Endoscopic examination was abnormal in 21 (65.6%). The positive predictive value of CRWT for abnormal endoscopic examination was 65.6%. Abnormal endoscopic examination revealed diverticulosis in 9 (43%), erythematous mucosa in 8 (38%), polyps in 6 (29%), mass in 2 (9%), thickened folds in 1 (5%), and diverticulitis in 1 (5%). Histopathological findings revealed colitis in 7 (33%), adenoma in 4 (19%), hyperplastic polyps in 4 (19%), adenocarcinoma in 2 (9%), lymphoid aggregates in 2 (9%), melanosis coli in 1 (5%), and normal in 1 (5%) in the abnormal examination group. Abnormal endoscopic examination was found in 65.6% of patients. The prevalence of colitis, adenomas, and malignancy was high, therefore abnormal CRWT warrants further endoscopic evaluation.
authors.affiliation: Division of Gastroenterology and Hepatology, Charles R. Drew University of Medicine and Science, UCLA School of Medicine, 12021 South Wilmington Avenue, MP 11, Los Angeles, California 90059, USA. manmeetpadda@cdrewu.edu
authors.forename: Manmeet
authors.initials: M
authors.lastname: Padda
authors.forename: Jaydutt
authors.initials: J
authors.lastname: Vadgama
authors.forename: Paramjit
authors.initials: P
authors.lastname: Sandhu
authors.forename: Anil
authors.initials: A
authors.lastname: Dev
authors.forename: Ioannis
authors.initials: I
authors.lastname: Giannikopoulos
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D003106:Colon / Q000000981:diagnostic imaging* / Q000473:pathology; D003108:Colonic Diseases / Q000000981:diagnostic imaging* / Q000208:ethnology / Q000473:pathology; D003113:Colonoscopy; D003937:Diagnosis, Differential; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D006984:Hypertrophy / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012002:Rectal Diseases / Q000000981:diagnostic imaging* / Q000208:ethnology / Q000473:pathology; D012007:Rectum / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014481:United States / Q000453:epidemiology