Posted By HFHSM.D.-jg on November 07, 1998 at 11:55:09:
In Reply to: SIGMOID COLON posted by Timothy Kerr on November 02, 1998 at 23:55:29:
I`m a 30 year old man that has had problem with my bowels all my life,constipation I have been having stomach pains for several years not severe untill about three weeks ago they started getting worse and I stay bloted all the time and when I eat is when the pains are worse.My docter recently done a ultrasound of the gallbladder,pancreas and bileducts the results said as follows normal ultrasound of the gallbladder and amylase,lipase and liver function tests had been normal as was the CBC.He also had lab work done and the following was off-MONO%10.3,TRIG 201,ALK-PHO 50.There was notes on ultrasound report that there was a small 5-6 mm.gallbladder polyp,no gallstones or biliory dilototion and only a portion of the pancreatic head was visualized because there was too much bowel gas to visualize the rest of the pancreas.He also done the endoyscopy found hiatal hernia,gastritis and said that my stomach linen was inflamed.The last ct scan of the abdomen & pelvis report is whats got me scared here`s what it reads there are some areas of incomplete distention however,of the distal descending colon & especially the sigmoid colon.The distal end of the sigmoid colon there appears to be an area of narrowing and wall thickening,in fact there may be several areas of narrowing in the distal sigmoid.I seem to be getting the run around from my docters office and I`m pretty scared about the test report that I just noted above!I have a 3 year old son that is my life and I just want to make sure that I am healthy.What do you think my problem is?Any suggestions?
Dear Timothy Kerr:
Your worry about the abdominal CT scan regarding the description of "wall thickening and narrowing of the distal sigmoid colon" is legitimate because it sounds very abnormal and scary. But such description of the abdominal CT scan happens frequently due to theincomplete distention of the colon. Abdominal CT scan is an excellent test for evaluating solid organs in the abdomen such as liver, kidney, pancreas, spleen, lymph nodes and for identifying abnormal strucutres e.g. abscesses. The CT scan, however, is not a good test for evaluating the intraluminal structures. When the large intestines are not distended during the CT scan (as we frequently see), the normal intestines wall collapses leading to narrowed lumen and thickened wall of the intestines on the CT scan image. But this kind finding is difficult for the radiologist to interpret and to differentiate whether there is a true thickening of the sigmoid colon from the CT scan image.
The thickened wall and narrowed lumen of distal sigmoid colon on your CT scan most like represent the UN-distended normal sigmoid colon. But given your chronic constipation and chronic abdominal pain , you should consider undergoing a lower GI work up with flexible sigmoidoscopy and barium enema or colonoscopy to confirm that there is no colonic problem.
This information is presented for educational purpose only. Always consult your doctor for specific medical questions.
*keywords: colon, CT scan
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