Clinical significance of incidental colorectal wall thickening on computed tomography scan in african-american and hispanic patients

• Published in: Digestive diseases and sciences Vol. 52; no. 11; pp. 3159 - 3164
• Main Authors: PADDA, Manmeet, VADGAMA, Jaydutt, SANDHU, Paramjit, DEV, Anil, GIANNIKOPOULOS, Ioannis
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01-11-2007; Springer Nature B.V
• Subjects: Adult; African Americans; Aged; Biological and medical sciences; Colon - diagnostic imaging; Colon - pathology; Colonic Diseases - diagnostic imaging; Colonic Diseases - ethnology; Colonic Diseases - pathology; Colonoscopy; Diagnosis, Differential; Digestive system. Abdomen; Endoscopy; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology. Liver. Pancreas. Abdomen; Hispanic Americans; Humans; Hypertrophy - diagnostic imaging; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Other diseases. Semiology; Predictive Value of Tests; Prevalence; Rectal Diseases - diagnostic imaging; Rectal Diseases - ethnology; Rectal Diseases - pathology; Rectum - diagnostic imaging; Rectum - pathology; Retrospective Studies; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tomography, X-Ray Computed - methods; United States - epidemiology; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Adenocarcinoma; Skin disease; Prevalence; Mucosa; Adenoma; Epidemiology; Inflammatory disease; Histopathology; African-Americans .Hispanics; Colonoscopy; Gastroenterology; Intestinal disease; Benign neoplasm; Colon; Endoscopy; CT scan; Polyp; Human; Pigmentation disorder; Radiodiagnosis; Metabolic diseases; Malignant tumor; Colorectal wall thickening; Crohn disease; Diverticulitis; Rectum; Digestive diseases; Medical imagery; Diverticulosis; Melanosis; Computerized axial tomography; Colitis; Erythema; Predictive factor; African American; Ulcerative colitis
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-006-9639-6

We sought to assess the significance of an incidental finding of colorectal wall thickening (CRWT) on computed tomography (CT) scan in African-American and Hispanic patients. We retrospectively reviewed charts of African-American and Hispanic patients from January 1994 to December 2005. Those patients were included in whom the colonoscopy was performed due to incidental CRWT on CT scan. Patients with a history or a family history of colorectal malignancy, inflammatory bowel disease, or colorectal surgery, with an incomplete colonoscopic examination, or <18 years of age were excluded. Endoscopic and pathological findings were abstracted. Thirty-two patients met the criteria. Endoscopic examination was abnormal in 21 (65.6%). The positive predictive value of CRWT for abnormal endoscopic examination was 65.6%. Abnormal endoscopic examination revealed diverticulosis in 9 (43%), erythematous mucosa in 8 (38%), polyps in 6 (29%), mass in 2 (9%), thickened folds in 1 (5%), and diverticulitis in 1 (5%). Histopathological findings revealed colitis in 7 (33%), adenoma in 4 (19%), hyperplastic polyps in 4 (19%), adenocarcinoma in 2 (9%), lymphoid aggregates in 2 (9%), melanosis coli in 1 (5%), and normal in 1 (5%) in the abnormal examination group. Abnormal endoscopic examination was found in 65.6% of patients. The prevalence of colitis, adenomas, and malignancy was high, therefore abnormal CRWT warrants further endoscopic evaluation.