Endoscopic findings of the gastrointestinal tract and conjunctions with preceding tomography findings

Abstract

Aim: Abdominopelvic computed tomography is commonly used for delineating the causes of abdominal pain. While its popularity has increased, the rate of nonspecific findings like gastrointestinal wall thickening has also increased. We aimed to determine whether a CT finding of thickened wall predicted a pathological finding on subsequent endoscopic evaluation. Method: This retrospective study was conducted on adult patients who underwent endoscopic or colonoscopic evaluation at our center in 2019 and had a preceding abdominopelvic CT within a month before this investigation. Patients’ gastric or colonic wall thicknesses were measured during CT scans. Endoscopy or colonoscopy results of these patients were retrieved, and their correlation with wall thicknesses was analyzed. Results: The study cohort included 647 patients. While 106 (16.38%) underwent endoscopy, 541 (83.62%) underwent colonoscopy. The endoscopic biopsies were malignant in 101 patients (95,3%) and benign in 5 (4,7%) patients. The CT sections showed thickened wall in 93 (87.7%) patients. Comparison of the patients with and without a thickened wall revealed no difference concerning malignancy rates. Increased colonic wall thickness was detected in 506 (93,5%) of the CT sections. Normal or benign colonoscopic biopsy findings were reported in 19 (3,5%) patients. Adenocarcinoma was detected in 456 (84,2%) patients. Comparison of the patient groups with or without wall thickening did not reveal any significant differences regarding malignancy rates. Conclusion: Endoscopic-colonoscopic evaluations should be performed in patients with gastrointestinal wall thickening in CT scans since the diagnostic and predictive accuracy are limited when a single test like CT is used.