Computed Tomography Imaging Evaluation and Outcome of Isolated Sigmoid Colon Thickening

Abstract This research aimed to evaluate computed tomography (CT) imaging findings in patients presenting with isolated sigmoid colon wall thickening based on their CT studies and to correlate these with biopsy results. This retrospective observational study evaluated 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 portal venous phase CT studies, between January 2020 and January 2022. CT findings associated with the length of the affected sigmoid segment, mucosal pattern (symmetric or asymmetric), presence of diverticula, lymph nodes, and other additional features were documented. Age, gender, and CT findings were compared with outcomes, and associations were determined by the Chi-square test. Of the 30 patients (aged between 20 and 75 years), the majority were males (n = 21) and older than 40 years (n = 22). In n = 16 cases, the clinical picture was acute (without the presence of diverticula), and in n = 14 cases, it was chronic (with the presence of diverticula). Both findings were statistically significant with p = 0.01 for each. Acute presentation, younger patients, and the presence of diverticula on CT scans were associated with benign biopsies. Length of mucosal thickening of the affected segment (i.e., less than 10 cm) and the presence of diverticula exhibited the most effective predictive association for the benign outcome. Younger patients who present acutely and show diverticula on CT imaging may have benign causes of sigmoid thickening, which may ultimately require endoscopic evaluation to exclude malignancy, particularly in cases of complicated diverticulitis or when CT finds are challenging.