Clinical Significance of Bowel Wall Thickening Detected with 64-Slice Multidetector Computed Tomography

Abstract

Background/Aims: The multidetector computed tomography (MDCT) scanning frequently leads to the incidental discovery of bowel wall thickening. The aim of this study was to determine the utility of gastroscopy and colonoscopy in the management of patients who had incidental discovery of bowel wall thickening on MDCT. Methods: From May 2006 to March 2008, the abdominal MDCT reports of all patients in Chungbuk NationalUniversity Hospital were reviewed. Cases with any bowel thickening was selected and then patients who received gastroscopy or colonoscopy after abdominal MDCT were re-selected. Results: Gastroscopy revealed abnormal findings in 22 (95.7%) out of 23 patients, and 10 patients (43.5%) had stomach cancers. Colonoscopy revealed abnormal findings in 35 (85.4%) out of 41 patients, and 12 patients (29%) had malignant tumors. In the patients who had lymph node enlargement (p＜0.001), dirty fat infiltration (p=0.025), and irregular wall thickening (p ＜0.001) on MDCT malignancy was observed more frequently. Conclusions: We recommend gastroscopy and co-

Colonoscopy for colonic wall thickening at computed tomography: a worthwhile pursuit?

“…Colonic wall thickening is frequently encountered at CT and may be related to normal variants such as diverticular disease, inflammatory conditions, and neoplastic disease [1]. Because no uniform guidance exists, debate surrounds the clinical significance of bowel wall thickening found at CT when demonstrated by both abdominopelvic CT (APCT) or CT colonography (CTC) [2][3][4][5][6][7][8][9][10][11][12][13].…”

“…A common dilemma facing clinicians is how best to follow up a CT report describing colonic wall thickening [2][3][4][5][6][7][8]. In short, how confident can the referring clinician be with the radiologist's diagnosis to explain a new finding of colonic thickening?…”