title: Computed tomography findings of bowel wall thickening: its significance and relationship to endoscopic abnormalities.
abstract: BACKGROUND
  The aim of this study was to conduct retrospective analysis of abdominopelvic computed tomography (CT) reports, identifying those patients in whom bowel wall thickening (BWT) was observed, and to correlate these reports with subsequent endoscopic evaluation.
  
  
  METHODS
  Formal reports for all patients undergoing abdominopelvic CT between February 2007 and September 2009 were reviewed. Where patients were identified as having colorectal 'wall thickening', results of subsequent endoscopic evaluations were documented. Only those patients with a report of BWT  who had follow-up endoscopy (colonoscopy, sigmoidoscopy) were included in the analysis.
  
  
  RESULTS
  A total of 165 patients were included. Abnormalities on endoscopy at the exact site of the BWT on CT were found in 95 patients (57.58%); in 36 cases (21.82%) this was a malignant lesion. BWT  of the transverse colon was significantly more likely to correspond to an endoscopic finding of cancer than other sites (p=0.034). Rectal bleeding was reported significantly more often in patients with BWT and neoplastic disease on endoscopy compared with those with normal endoscopy  (p=0.04). Excluding patients with inflammatory/diverticular lesions, 59.02% of Caucasians had a neoplastic lesion at the site of reported BWT, significantly higher than the other ethnic groups (p=0.008). There were 38 patients (23.03%) who did not present with bowel symptoms  and, of these, 6 were diagnosed subsequently with colorectal cancer.
  
  
  CONCLUSIONS
  This study supports endoscopic evaluation to investigate patients with CT evidence of BWT, especially in cases involving the transverse colon, in Caucasian patients or in association with symptoms of rectal  bleeding.
authors.affiliation: Department of colorectal surgery, North Middlesex University Hospital, London UK. mohsinuzzaman@yahoo.co.uk
authors.forename: M M
authors.initials: MM
authors.lastname: Uzzaman
authors.forename: A
authors.initials: A
authors.lastname: Alam
authors.forename: M S
authors.initials: MS
authors.lastname: Nair
authors.forename: R
authors.initials: R
authors.lastname: Borgstein
authors.forename: L
authors.initials: L
authors.lastname: Meleagros
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000473:pathology*; D000328:Adult; D000368:Aged; D002432:Cecum / Q000473:pathology; D003092:Colitis / Q000473:pathology; D003106:Colon / Q000473:pathology; D003110:Colonic Neoplasms / Q000473:pathology*; D023881:Colonography, Computed Tomographic / Q000379:methods; D003967:Diarrhea / Q000209:etiology; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000473:pathology; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D012002:Rectal Diseases / Q000209:etiology / Q000473:pathology; D012004:Rectal Neoplasms / Q000473:pathology*; D012007:Rectum / Q000473:pathology; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed / Q000379:methods
chemical_list: D006454:Hemoglobins