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CC BY 4.0 · Ibnosina Journal of Medicine and Biomedical Sciences
DOI: 10.1055/s-0045-1815705
Original Article

Computed Tomography Imaging Evaluation and Outcome of Isolated Sigmoid Colon Thickening

Authors

  • Khawaja Bilal Waheed

    1   Department of Radiology, King Fahad Military Medical Complex, Dhahran, Saudi Arabia

  • Alexander Woodman 

    2   School of Health Sciences, University of Salford, Manchester, United Kingdom

  • Lamiaa H. Al-Jamea

    3   Department of Academic Affairs and Training, King Fahad Military Medical Complex, Dhahran, Saudi Arabia

  • Arulanantham Z. Jebakumar

    4   Postgraduate Studies and Scientific Research Department, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia

  • Meshari Abdullah Hamad Al-Faris

    1   Department of Radiology, King Fahad Military Medical Complex, Dhahran, Saudi Arabia

Funding and Sponsorship None.
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Abstract

Background

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.

Materials and Methods

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.

Results

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.

Conclusion

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.

Keywords

computed tomography - sigmoid colon thickening - colonic malignancies - benign and malignant - diverticulitis

Authors' Contributions

K.B.W. conceptualized the draft and prepared its methodology. A.W. and L.H.A. validated the draft. K.B.W., A.Z.J., and M.A.H.A. did the formal analysis. K.B.W. wrote and prepared the original draft. A.W. and L.H.A. wrote, reviewed, and edited the manuscript. K.B.W., A.W., L.H.A., A.Z.J., and M.A.H.A. visualized the manuscript. All authors read and agreed to the published version of the manuscript.


Compliance with Ethical Principles

The study was approved by King Fahad Military Medical Complex Ethics Committee. The need for informed written consent was waived considering its retrospective nature and non-disclosure of patient information. The research was conducted in accordance with the Helsinki Declaration.




Publication History

Article published online:
16 January 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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