title: [Clinical significance of the large intestinal wall thickening detected by abdominal computed tomography].
abstract: OBJECTIVE
  Bowel wall thickening on CT has been reported to reflect colorectal carcinoma and colitis. The aim of this study was to evaluate the clinical significance of the large intestinal wall thickening on CT.
  
  
  METHODS
  Between January 2006 and August 2010, medical records of 815 patients who underwent endoscopy after CT scans within 1 month were reviewed retrospectively.
  
  
  RESULTS
  A total of 233 patients were included. The wall thickening was actually associated with abnormal endoscopic findings in 81.1% of the cases. The accuracy rate on diagnosis between CT and endoscopy was 63.5%. The discrepancy in diagnosis was higher in cases with left colon abnormality and short segment lesion. Abdominal pain was significantly more common in cases suspected malignancy on CT compared with colitis (p=0.047). Most of the malignancy diagnosed on CT involved the left side colon and most of the colitis involved the entire colon (p<0.001). The length of lesion was below 5 cm in 86.5% of the malignancy. Malignancy was more common in patients aged over 50 years with hemoglobin below 12 g/dL. The CT findings significantly suggestive of malignancy were lymph node enlargement and length of lesion below 5 cm (p=0.027 and p<0.001).
  
  
  CONCLUSIONS
  The large intestinal wall thickening on CT was limited in the differential diagnosis of malignancy and colitis. Additional endoscopic evaluation is needed in patients with bowel wall thickening associated with lymph node enlargement and short segment lesion on CT in order to exclude malignancy.
authors.affiliation: Department of Internal Medicine, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 705-717, Korea.
authors.forename: Jung Soo
authors.initials: JS
authors.lastname: Lee
authors.forename: Joon Hyun
authors.initials: JH
authors.lastname: Cho
authors.forename: Kyeong Ok
authors.initials: KO
authors.lastname: Kim
authors.forename: Si Hyung
authors.initials: SH
authors.lastname: Lee
authors.forename: Byung Ik
authors.initials: BI
authors.lastname: Jang
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003092:Colitis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003113:Colonoscopy; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007420:Intestine, Large / Q000503:physiopathology*; D008198:Lymph Nodes / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D006454:Hemoglobins