DOI: https://doi.org/10.36347/sasjm.2024.v10i12.004

Pages: 1381-1384

Introduction: Digestive thickening on cross-sectional imaging is a challenge for gastroenterologists in cancer diagnosis. The aim is to study the contribution of ileocolonoscopy in the etiological assessment of digestive thickening visualized on imaging. Materials and Methods: This was a single-center study conducted from February 2019 to July 2024, including all patients with digestive thickening on cross-sectional imaging who underwent ileocolonoscopy. Results: Of a total of 2030 patients who underwent colonoscopy, 145 patients (7.14%) had digestive thickening on imaging. The mean age was 50.5 years, with a female predominance (sex ratio 0.82). 18 patients (12,5%) had a pathological history. Digestive thickening was discovered incidentally on imaging in 36 cases (24.8%), while 109 patients (75.2%) were symptomatic: 29% with abdominal pain, 19,3% with transit disorders, 11% with rectal syndrome, 7,6% with occlusive syndrome, 2,8% with iron-deficiency anemia, 2% with rectal bleeding, and 3,5% of patients had melaena. Colonoscopy was pathological in 83 cases (57,2%) and revealed the following lesions: ulcerative-bourgeoning tumor in 44 cases (30%) (of these, 15.8% in caecum, 11,8% in right colon, 38,16% in sigmoide, 13,16% left colon, 2,6% in transverse colon and 18.4% in recta), terminal ileitis in 18 cases (12,4%) (ulcerated in 54,8% of cases, stenosing in 32,2% and nodular in 13%), inflammatory colonic stenosis in 11 cases (7,6%), inflammatory pancolitis in 2 case (1,4%) and ulcerative rectitis in 8 cases (5,5%). Colonoscopy was normal in 62 cases (42,8%). Conclusion: Digestive thickening on cross-sectional imaging requires rigorous exploration to avoid missing a cancer. However, in our study, colonoscopy did not reveal a pathological lesion in more than a third of cases, requiring a review of the imaging technique and results.