Endoscopic evaluation of patients with gastric wall thickening detected with computed tomography

Baş, Bilge

doi:10.14744/less.2019.64436

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…A careful endoscopic examination is required to determine whether the increase in wall thickness is malignant, benign, or normal. 3,4 The average wall thickness threshold in the upper and lower gastrointestinal tract is 5 mm. 5,6 Gastrointestinal wall thickening (GWT) is often related to antral gastritis in the stomach or noninfectious colitis in the colon.…”

Section: Introductionmentioning

confidence: 99%

Incidentally Detected Gastrointestinal Wall Thickness on Abdominal Computed Tomography; What Does it Mean for Endoscopy?

et al. 2021

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Background: The clinical significance of gastrointestinal wall thickening (GWT) on abdominal computed tomography (CT) is not certain, yet. Despite the need for clinical guidelines describing the importance and evaluation of GWT on a CT scan, there have been few studies evaluating these incidental imaging abnormalities. The aim of this study is to endoscopically evaluate certain etiologies that cause incidental GWT found on CT. Methods: This retrospective cohort study was carried out with patients who had incidentally detected GWT on a CT scan at the Kanuni Sultan Süleyman Training and Research Hospital between February 2016 and December 2018. Results: A total of 129 patients (62 males and 67 females; mean age 57.5 years, range: 26-87 years) were included in the study. Abnormalities observed during endoscopy at the exact site of the GWT noted on a CT image were found in 114 patients (99%): upper endoscopy revealed malignancy in 33 (29%), gastritis in 63 (52%), hiatal hernia in 19 (16%), a gastric ulcer in 7 (6%), and alkaline gastritis in 3 (2%). Colonoscopy revealed malignancy in 4 (33%), benign polyps in 5 (35%), colonic ulcer in 2 (16%), and 2 patients (16%) had normal findings. Malignancy was detected more frequently in the cardioesophageal region compared with the antrum (P = 0.020). Conclusion:In this study, detection of GWT on CT often indicated pathologies which were subsequently confirmed endoscopically. Pathological findings were detected in 83% of these patients, with approximately 30% determined to be malignant. Endoscopic evaluation is recommended when GWT is reported on a CT scan.

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Section: Introductionmentioning

confidence: 99%

Incidentally Detected Gastrointestinal Wall Thickness on Abdominal Computed Tomography; What Does it Mean for Endoscopy?

et al. 2021

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Endoscopic Significance of Incidental Upper Gastrointestinal Wall Thickness Detected on Computed Tomography Scans

Idrees,

Khan,

Khan

2024

Cureus

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Background Incidental upper gastrointestinal wall thickness (GIWT) is a nonspecific finding often observed on computed tomography (CT) scans performed to investigate patients admitted with various symptoms both gastrointestinal (GI) and non-GI. Its clinical significance is uncertain, and patients often undergo endoscopic evaluation under an urgent cancer pathway to exclude malignancy. We aimed to conduct this study to determine how well the CT findings correlated endoscopically. Methods A retrospective data collection was performed for patients who were referred to the endoscopy department between July 2021 and July 2024 for evaluation of GIWT over a period of four years. We analyzed age, gender, reason for initial CT, endoscopic findings, histology findings, and evidence of cancer. Results Our final cohort included 50 patients who underwent endoscopic and subsequent histological examination following abnormal CT findings. The mean age of the included cohort was 71. Thirty-one were males and 19 patients were females. Ninety percent had esophageal wall thickness while 10% had gastric wall thickness. Twenty-six percent of patients had red flag symptoms such as weight loss and iron deficiency anemia as an indication for undergoing CT scans. About 8% of the patients were confirmed to have malignancy on endoscopy of which 6% had red flag symptoms such as weight loss and iron deficiency anemia. Seventy-eight percent of the cohort had gastroscopy within two to four weeks, 10% in four to 12 weeks and 12% after 12 weeks. Conclusion Our results illustrate that a majority of people with incidental GIWT had benign pathologies whereas a small number of patients had malignancy. It is worth noting that malignancy was more common among patients who had red flag symptoms, and therefore urgent endoscopy assessment under the urgent cancer pathway is recommended in these patients. On the contrary, the risk is noted to be low in patients with no red flag symptoms, therefore we recommend assessing such patients individually for the need for endoscopic evaluation based on detailed history and examination. We think further multicenter large studies are required in this area of research and develop standard protocols in relation to investigating incidental upper GIWT with endoscopy.

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Endoscopic evaluation of patients with gastric wall thickening detected with computed tomography

Cited by 2 publications

References 11 publications

Incidentally Detected Gastrointestinal Wall Thickness on Abdominal Computed Tomography; What Does it Mean for Endoscopy?

Incidentally Detected Gastrointestinal Wall Thickness on Abdominal Computed Tomography; What Does it Mean for Endoscopy?

Endoscopic Significance of Incidental Upper Gastrointestinal Wall Thickness Detected on Computed Tomography Scans

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