What should we expect when colon wall thickening is detected on abdominal CT scan in the era of artificial intelligence?

AIM: Except for emergencies, endoscopic findings were investigated in patients with increased thickness of the colon wall on abdominal CT. MATERIAL AND METHODS: Patients who underwent colonoscopy due to the detection of thickening of the colon wall in the abdominal CT performed for non-emergency reasons in the General Surgery Clinic of Health Sciences University Haseki Training and Research Hospital between January 2018 and December 2020 were evaluated retrospectively. Data were obtained by scanning the hospital database. RESULTS: Fifty-four patients who underwent colonoscopy after incidentally detected increased colonic wall thickening determined from the hospital database. Endoscopic examinations revealed tumors in 30 patients (55.6%), inflammatory bowel disease (IBD) in 9 patients (16,6%), nonspesific colitis in 1 patient (1,9%), polyps in 3 patients (5,6%), and diverticula in 2 patients (3.7%). No pathology was detected in 9 patients (16.6%). Patients were aged between 21 and 87 (mean 59,04 years, SD ± 18,54). DISCUSSION: Tumor is the primary endoscopy finding in cases where an increase in colon wall thickness is detected incidentally on abdominal CT, except in emergencies. We performed this preliminary study in the near future to determine the diagnostic algorithm with the use of artificial intelligence in radiology and thus avoid unnecessary investigations. CONCLUSION: In our study, the main reason for the incidentally detected increase in colon wall thickness is the tumor. A diagnostic algorithm can be created with machine learning, a subcomponent of artificial intelligence. KEY WORDS: Artificial intelligence, Bowel wall thickening, Colonoscopy, Computed tomography.

Changing the Surgical Approach to Breast Diseases During the COVID-19 Pandemic Period.

Background Postponing elective surgeries during the COVID-19 pandemic has also affected the approach to both malignant and benign breast diseases. This paper aims to share how the COVID-19 pandemic affects our approach to breast cancer, benign breast cases, and the procedures' results. Methodology A cross-sectional study was conducted in a tertiary-level public hospital in Istanbul, Turkey. We retrospectively analyzed our treatment options for patients diagnosed with breast cancer and benign breast disease in the general surgery clinic of a tertiary hospital that declared a pandemic status between March 11, 2020, and June 1, 2020. Results The number of patients who visited the breast outpatient clinic and received a diagnosis of breast cancer was 23. Among the benign diseases, no intervention was made except for abscess (eight patients, 40%) and mastitis (12 patients, 60%). Conclusions Patients with acute abscesses and mastitis were treated for both diagnostic and therapeutic purposes. Chemotherapy and hormone therapy were chosen for those diagnosed with cancer. Priority was given to oncology protocols rather than surgical approaches during the pandemic. We think that different approaches will be defined as the pandemic continues.

Evaluation of patients undergoing emergency surgery in a COVID-19 pandemic hospital: a cross-sectional study

ABSTRACT BACKGROUND: The COVID-19 pandemic is threatening healthcare systems and hospital operations on a global scale. Treatment algorithms have changed in general surgery clinics, as in other medical disciplines providing emergency services, with greater changes seen especially in pandemic hospitals. OBJECTIVES: To evaluate the follow-up of patients undergoing emergency surgery in our hospital during the COVID-19 pandemic. DESIGN AND SETTING: Cross-sectional study conducted in a tertiary-level public hospital. METHODS: The emergency surgeries carried out between March 11 and April 2, 2020, in the general surgery clinic of a tertiary-care hospital that has also taken on the functions of a pandemic hospital, were retrospectively examined. RESULTS: A total of 25 patients were included, among whom 20 were discharged without event, one remained in the surgical intensive care unit, two are under follow-up by the surgery service and two died. Upon developing postoperative fever and shortness of breath, two patients underwent thoracic computed tomography (CT), although no characteristics indicating COVID-19 were found. The discharged patients had no COVID-19 positivity at follow-up. CONCLUSION: The data that we obtained were not surgical results from patients with COVID-19 infection. They were the results from emergency surgeries on patients who were not infected with COVID-19 but were in a hospital largely dealing with the pandemic. Analysis on the cases in this study showed that both the patients with emergency surgery and the patients with COVİD infection were successfully treated, without influencing each other, through appropriate isolation measures, although managed in the same hospital. In addition, these successful results were supported by 14-day follow-up after discharge.

Evaluation of patients undergoing emergency surgery in a COVID-19 pandemic hospital: a cross-sectional study.

BACKGROUND: The COVID-19 pandemic is threatening healthcare systems and hospital operations on a global scale. Treatment algorithms have changed in general surgery clinics, as in other medical disciplines providing emergency services, with greater changes seen especially in pandemic hospitals. OBJECTIVES: To evaluate the follow-up of patients undergoing emergency surgery in our hospital during the COVID-19 pandemic. DESIGN AND SETTING: Cross-sectional study conducted in a tertiary-level public hospital. METHODS: The emergency surgeries carried out between March 11 and April 2, 2020, in the general surgery clinic of a tertiary-care hospital that has also taken on the functions of a pandemic hospital, were retrospectively examined. RESULTS: A total of 25 patients were included, among whom 20 were discharged without event, one remained in the surgical intensive care unit, two are under follow-up by the surgery service and two died. Upon developing postoperative fever and shortness of breath, two patients underwent thoracic computed tomography (CT), although no characteristics indicating COVID-19 were found. The discharged patients had no COVID-19 positivity at follow-up. CONCLUSION: The data that we obtained were not surgical results from patients with COVID-19 infection. They were the results from emergency surgeries on patients who were not infected with COVID-19 but were in a hospital largely dealing with the pandemic. Analysis on the cases in this study showed that both the patients with emergency surgery and the patients with COVID infection were successfully treated, without influencing each other, through appropriate isolation measures, although managed in the same hospital. In addition, these successful results were supported by 14-day follow-up after discharge.