title: Colonic bowel wall thickening: is there a need for endoscopic evaluation?
abstract: OBJECTIVE
  Clinical relevance of colonic bowel wall thickening seen on abdominal CT scans is unknown. Recommendations for further diagnostic procedures are lacking. The aim of this retrospective study was to evaluate detecting of bowel wall thickening on CT scan and findings that were seen in case of endoscopical evaluation.
  
  
  METHODS
  The radiological database was retrospectively reviewed for all reports of CT scans from 2003 to 2009 at the University Hospital Regensburg, Germany. Patients with underlying diseases for suspected bowel wall thickening were excluded.
  
  
  RESULTS
  Sixty-two patients with bowel wall thickening were detected. Twenty-one percent (13/62) had generalized bowel wall thickening. In 58%, bowel wall thickening was limited to one segment of the colon (36/62), mostly left sided (25/62). Forty-four percent of patients (27/62) were sent to endoscopy. In 15% (4/27), malignancy was suspected, and it could be histologically confirmed in two patients. Nineteen percent (5/27) had normal endoscopy, and 67% (18/62) showed benign findings.
  
  
  CONCLUSIONS
  Colonic bowel wall thickening is not a common finding on CT scan in this study. Consequential endoscopic evaluation was performed in less than 50% of patients. Pathological findings were detected in 80% of these patients. We recommend endoscopical evaluation if bowel wall thickening is reported on CT scan.
authors.affiliation: Department of Internal Medicine I, University of Regensburg, 93042 Regensburg, Germany. martina.troppmann@klinik.uni-regensburg.de
authors.forename: Martina
authors.initials: M
authors.lastname: Troppmann
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Lippert
authors.forename: Okka W
authors.initials: OW
authors.lastname: Hamer
authors.forename: Gabriele
authors.initials: G
authors.lastname: Kirchner
authors.forename: Esther
authors.initials: E
authors.lastname: Endlicher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000000981:diagnostic imaging / Q000473:pathology*; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed; D055815:Young Adult