Eskaros Saphwat, Ghevariya Vishal, Diamond Ilysa, Anand Sury
Division of Gastroenterology, Brooklyn Hospital Center, Brooklyn, NY 11201, USA.
Emerg Radiol. 2009 Nov;16(6):473-6. doi: 10.1007/s10140-009-0806-x. Epub 2009 Mar 19.
Incidental colon wall thickening is a common finding on computed tomography (CT) scans obtained in patients presenting to the emergency department. Currently, there are no guidelines for the emergency department physician or primary care physician regarding the need for further evaluation, specifically colonoscopy, in these patients. A retrospective review of 2,850 abdominopelvic CT scans performed from April 2006 to September 2006 was conducted. Three hundred twenty-two patients had incidental colon wall thickening and 150 of these patients had a subsequent colonoscopy. This study focused on those 150 patients and analyzed the correlation between the CT scan findings of wall thickening of the colon and the findings on colonoscopy. The CT scan findings correlated with abnormal colonoscopic findings in 96 out of 150 (64%) of our cases. In a specific subgroup, 12 out of 12 (100%) of these CT scans were also noted to have a mass lesion, as well as colon wall thickening, all of which were consistent with an adenoma or carcinoma found on colonoscopy. Incidental colorectal wall thickening at CT scan is due to nonspecific colitis in majority of the cases. Admission to the hospital should be based upon criteria other than this incidental radiological finding. However, patients with colorectal wall thickening with a mass lesion at CT scan should be followed closely as inpatient or outpatient given the high correlation with significant findings on colonoscopy.
在急诊科就诊患者的计算机断层扫描（CT）中，偶然发现结肠壁增厚是一种常见情况。目前，对于急诊科医生或初级保健医生而言，尚无关于这些患者是否需要进一步评估（特别是结肠镜检查）的指南。对2006年4月至2006年9月期间进行的2850例腹部盆腔CT扫描进行了回顾性研究。322例患者偶然发现结肠壁增厚，其中150例患者随后接受了结肠镜检查。本研究聚焦于这150例患者，分析了结肠壁增厚的CT扫描结果与结肠镜检查结果之间的相关性。在我们的150例病例中，有96例（64%）的CT扫描结果与结肠镜检查异常结果相关。在一个特定亚组中，这12例CT扫描均发现有肿块病变以及结肠壁增厚，所有这些在结肠镜检查中均与腺瘤或癌相符。CT扫描偶然发现的结直肠壁增厚在大多数情况下是由于非特异性结肠炎所致。住院应基于除这一偶然的影像学发现之外的其他标准。然而，鉴于CT扫描发现结直肠壁增厚伴有肿块病变与结肠镜检查的显著发现高度相关，此类患者应作为住院患者或门诊患者密切随访。
