Yes, CT Abdomen with IV Contrast Would Detect Ascending Colon Inflammation
A CT scan of your abdomen with IV contrast would have detected inflammation of your ascending colon if it was present. CT with IV contrast has high sensitivity and specificity for detecting colonic inflammation, including in the right colon (cecum and ascending colon), and is the imaging examination of choice for evaluating acute abdominal pain with suspected inflammatory bowel conditions 1.
Why CT with IV Contrast Is Effective for Detecting Ascending Colon Inflammation
IV contrast is essential for detecting bowel wall inflammation because it allows visualization of abnormal mural enhancement, wall thickening, and pericolonic inflammatory changes that characterize active colonic inflammation 1.
The American College of Radiology emphasizes that CT with IV contrast improves characterization and detection of subtle bowel wall abnormalities, with reported overall accuracy of 98% for detecting colonic inflammatory processes 1.
Specific findings visible on CT include thickening of the intestinal wall, mural enhancement with stratification, pericolonic fat stranding, and associated complications like abscesses—all of which would be apparent if your ascending colon was inflamed 2, 3, 4.
Evidence from Right-Sided Colon Inflammation
Multiple case series confirm that CT successfully identifies inflammation of the cecum and ascending colon, with CT findings of wall thickening and pericolonic inflammation present in all patients with right-sided colonic inflammatory disease 2, 3.
CT detected ascending colon diverticulitis in seven consecutive patients presenting with right lower quadrant pain, identifying both the inflammation and associated abscesses in all cases 2.
Even subtle or chronic inflammation of the ascending colon produces visible CT changes, including wall thickening with stenosis and adjacent retroperitoneal inflammation 3.
Important Caveats About CT Sensitivity
The scan must include IV contrast to reliably detect inflammation—non-contrast CT has "markedly poorer performance" and can only infer inflammation by secondary findings like wall thickening, potentially missing active disease 1, 5.
Your scan was ordered for right lower quadrant evaluation, which means the ascending colon was definitely included in the imaging field and would have been assessed 2, 3.
CT evaluates both the bowel wall and surrounding tissues, giving it an advantage over endoscopy alone by detecting extraluminal inflammation, fat stranding, and complications 1, 4, 6.
What This Means for Your Situation
If the radiologist reported no abnormalities in your ascending colon, you can be reasonably confident that significant inflammation was not present at the time of the scan 1, 2.
However, very mild or early mucosal inflammation might occasionally be missed on standard CT, though this would typically not cause significant symptoms 1, 7.
If you continue to have symptoms despite a normal CT, colonoscopy with direct visualization and biopsy remains the reference standard and can detect mucosal changes not visible on imaging 7, 6.