Outcomes of Isolated Sigmoid Colon Thickening Detected on Routine Computed Tomography Examinations

Abstract

Objective To determine outcomes of isolated sigmoid colon thickening detected on computed tomography (CT) and to evaluate certain clinical and CT findings that could help in diagnoses. Method This retrospective observational study was performed evaluating CT imaging data of all consecutive adult patients who presented with acute lower abdominal pains in emergency departments and were found to have isolated sigmoid colonic thickening on routine venous phase CT studies, between January 2020 to January 2022. Pre- viously operated cases, known inflammatory bowel disease patients, and those with known sigmoid malignancies were excluded. CT findings regarding the length of the sigmoid segment affected (less or more than 10 cm), mucosal pattern (symmet- ric or asymmetric), presence of diverticula, lymph nodes, and additional features (pericolic abscess or fistula formation, extra-luminal air foci or perforation, local invasion) were documented. Two experienced radiologists made consensus report- ing. Final diagnoses were confirmed on (endoscopic) biopsy results. Patients who did not have endoscopies or were medically treated were excluded. Age, gender, and CT findings were compared with outcomes, and any association was determined by the Chi-squared test. Results Out of 30 patients (aged between 20-75 years), the majority were males (n=21) and above 40 years (n=22). Twelve patients had colonic malignancies while 18 had benign findings. Acute presentation, younger patients, and those showing the presence of diver- ticula on CT scans were associated with benign biopsies. Conclusion Younger patients who present acutely and show diverticula on CT imaging may have benign causes of sigmoid thickening.