P1912 - Retrospective Analysis of The Correlation Between Abnormal CT Scan Findings and Colonoscopy Results

Khaled Elsokary, DO¹, Osama Alshakhatreh, MD¹, Ibrahim Mohammed, MD¹, Shunsa Tarar, DO¹, Paul J. Feustel, PhD¹, Tyler Richter, MS¹, Madeline Cleary, DO¹, Stephen Hasak, MD, MPH^2
1Albany Medical Center, Albany, NY; ²Albany Medical College, Albany, NY

Introduction: Patients presenting with gastrointestinal symptoms and abnormal CT scan findings often require further evaluation through colonoscopy. Currently, there are no guidelines specifying which abnormal CT findings necessitate a colonoscopy. Our study aims to determine the correlation between abnormal CT scan findings and colonoscopy results.

Methods: In our retrospective study, we included 197 patients who were presented to our hospital with a range of gastrointestinal symptoms, including abdominal pain, weight loss, gastrointestinal bleeding, and diarrhea. We reviewed the CT abdomen and pelvis imaging findings and correlated them with the results obtained from colonoscopy.

Results: A total of 197 patients with abnormal CT findings in the lower GI tract underwent colonoscopy. The mean age of the patients was 58 years, with 51% being female. Among these patients, 123 had colon wall thickening, 44 had a colon mass, 21 had diverticulosis, 4 had diverticulitis, and 45 had obstruction on the CT scan. Of the 123 patients with colon wall thickening, colonoscopy revealed that 44 (36%) had colitis, 12 (10%) had a mass, 4 (3%) had diverticulitis, and the remainder had nonspecific findings including internal hemorrhoids and polyps. Of the 44 patients with a colon mass on CT, 25 (57%) were confirmed to have a colon mass on colonoscopy. While 21 patients had diverticulosis on CT, 65 were found to have diverticulosis on colonoscopy.



Regression analysis indicated that the odds ratio for colitis with colon wall thickening was significant (OR 3.4, 95% CI 1.6-7.4, P < 0.001). The odds ratio of having a colon mass with findings of wall thickening and a mass on CT imaging were significant (OR 0.2, 95% CI 0.14-0.48, P = 0.003) and (OR 16.9, 95% CI 7.2-39.9, P < 0.001), respectively. The odds of having diverticulosis with colon diverticulosis on colonoscopy are significant (OR 4.9, 95% CI 1.8-12.8, P = 0.001). The correlation between CT-detected obstructions and masses identified on colonoscopy were insignificant (Table 1).

Discussion: Most lower GI findings identified on CT scans correlate with colonoscopy results. Our study shows that among the 44 patients with masses and the 123 patients with colon wall thickening identified on CT imaging, 37 patients were diagnosed with adenocarcinoma of the colon, and 53 patients were diagnosed with colitis. These findings highlight the importance of conducting colonoscopy evaluations when abnormal CT findings are present without a clear cause.


Disclosures:


Khaled Elsokary, DO¹, Osama Alshakhatreh, MD¹, Ibrahim Mohammed, MD¹, Shunsa Tarar, DO¹, Paul J. Feustel, PhD¹, Tyler Richter, MS¹, Madeline Cleary, DO¹, Stephen Hasak, MD, MPH². P1912 - Retrospective Analysis of The Correlation Between Abnormal CT Scan Findings and Colonoscopy Results, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.