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Possibilities of computed tomography in the diagnosis of large intestine diseases

Koshelev E.G., Kitayev S.V., Belyaev G.Yu., Egorov A.A., Shternis T.A.

Purpose. To reveal the possibilities of multislice computed tomography (CT) performed according to the standard protocol using intravenous bolus contrast enhancement in the diagnosis of diseases of the large intestine (LI) on the basis of one of the common symptoms – "wall thickening".

Materials and methods. The analysis of 359 CT studies of the abdominal cavity performed by the standard protocol in patients admitted to the surgical and gastroenterological departments with established diagnoses of diseases of the LI.

Results and discussion. Thickening of the wall of the colon (LI) was easily determined visually, equally marker, a symptom of LI pathology detected by computed tomography (p=0.0001). The thickening of the wall of the LI was considered at 5 mm or more. By the length of the thickening of the large intestine walls, the patients were divided into 3 groups: with focal (less than 100 mm), segmental (100-400 mm) and diffuse (more than 400 mm) thickening. Focal thickening of the LI wall was found in 191 cases (53%), segmental -108 (30%), diffuse – 60 (17%). The causes of thickening of the LI wall were tumors, inflammatory diseases and ischemia, as well as secondary changes in systemic diseases and diseases with impaired blood flow and ischemia. All revealed intestinal wall thickenings of diffuse nature reflected the manifestation of inflammatory processes, different genesis of 60 patients (16.7%), with the absence of tumor genesis in this category (p=0.0001). Thickening of the wall of the LI of neoplastic origin (cancer, lymphoma) determined in 144 cases (40%), determined in the groups of focal (57%) and segmental (32%) thickenings were inferior in the incidence of benign changes - 215 cases (60%), with a predominant diffuse type, except for "recognizable" diverticulitis, characterized mainly by focal thickening. Non-specific inflammatory bowel diseases prevailed in the group of benign changes. Thickening of the LI wall accompanies both neoplastic and benign diseases, with the prevalence of the second and inflammatory diseases in them (p=0.0001).

Thus, the considered sign of "thickening" of the LI wall, in our study, was a marker and made it possible to clearly identify the pathologically altered portion of the LI in the standard abdominal CT.

1 - Central State Medical Academy of Department of Presidential Affairs. Moscow, Russia.

2 - N.I. Pirogov City Clinical Hospital №1.

3 - Polyclinic №2,

Department of Presidential Affairs.

4 - Clinical Diagnostic Center MEDSI. Moscow, Russia.

5 - Kemerovo State

Medical University the Ministry of Health of the Russian Federation.

Kemerovo, Russia.


Keywords: large intestine, wall thickness, colon cancer, CT signs of colon diseases.


Corresponding author:  Koshelev E.G., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript


For citation: Koshelev E.G., Kitayev S.V., Belyaev G.Yu., Egorov A.A., Shternis T.A. Possibilities of computed tomography in the diagnosis of large intestine diseases. REJR 2019; 9(4):106-122. DOI:10.21569/2222-7415-2019-9-4-106-122.


Received:        30.07.19 Accepted:       12.09.19