Correlation of Computed Tomography of Colonic Wall Thickening with Colonoscopy

Computed Tomography of abdomen frequently shows bowel wall thickening with different grades and characteristic of thickening. The correlation of bowel wall thickening (BWT) with endoscopic findings is not well described in Indian population. Therefore we did this study to determine the correlation of BWT with endoscopic findings.

Its Prospective single center study with 85 Consecutive patients with age group more than 12 years with CT scan abdomen showing bowel wall thickening were included in the study. Colonoscopy was done subsequently within a span of 15 days with appropriate bowel preparation. Colonoscopic correlation was done in relation to site, degree and characteristic of thickening. Biopsies were taken at the site of visible abnormalities on endoscopy and from normal appearing mucosa in case of strong suspicious of disease.

Total of 85 (37 men) consecutive symptomatic patients with colonic wall thickening on computed tomography underwent colonoscopy. The mean age group was 34.2 (SD±17.35) years. Endoscopy was normal in 20 patients (24%) and abnormal in 65 patients (76.5%). Patients with mild thickening were more likely to have normal endoscopy than those with moderate/severe thickening (19 versus 1 patient; p<0.001). The abnormality rate was similar across different bowel segments (left vs right side; 85.7% versus 76.5%, p< 0.57). Out of 65 patients with endoscopic abnormality, 41 (62.12%) had tuberculosis, 10 (15.16%) had malignancy. Most common cause of IC thickening was secondary to tuberculosis (n=40, 95.2%).

A proportion of patients with thickening on CT scan, especially mild, may have normal colonoscopy. Patients should be counseled about the same prior to colonoscopy. However, colonoscopy should be done to rule out abnormality even when CT shows mild thickening.