Correlation of CT Scan Findings in the Upper Gastrointestinal Tract Compared to Upper Endoscopy

Abstract

Purpose: Gastroenterology referral for evaluation of abnormal Computer tomography (CT) scans suggestive of upper gastrointestinal (GI) disease is frequent. At present there are no guidelines to stratify CT Scan findings that need to be pursued with endoscopy. There are few studies that have evaluated the role of gastrointestinal endoscopy in this context with different conclusions. The present study aims to correlate the CT scan findings in the upper GI tract with upper endoscopy findings. Methods: Retrospective cohort study consisted of adult subjects who had an abnormal CT scan and an upper endoscopy performed. Patient records were reviewed for demographics, CT scan findings and endoscopy findings. Abnormal CT findings were co-related with endoscopic findings. Results: 36 subjects had abnormal findings in the upper GI tract on CT scan and were investigated with an upper endoscopy. Mean age of our subjects was 60.69 years (24-89), and 58.33% were female. The CT scan findings correlated with abnormal upper endoscopy in 25/36(69.44%) subjects. 34 subjects had wall thickening on CT scan, 1 had a filling defect in the stomach and 1 had a duodenal mass like lesion. Of these 34 patients with wall thickenings, 26/34 (76.4%) had wall thickening in stomach, 5 in duodenum, 2 in esophagus, and 1 in jejunum. Upper gastrointestinal endoscopy of these 34 patients revealed; 17(50%) patients had chronic gastritis, 3 patients had gastric ulcers, 2 patients had gastric erosions, and 2 had duodenitis. The patient with duodenal mass like lesion was found to have a mass on upper endoscopy. Biopsy of the mass revealed chronic inflammation. The patient with filling defect had chronic gastritis. No cancers were found. Conclusion: Majority of the upper GI findings in CT scans can be attributed to gastritis and peptic ulcer disease. All abnormal CT scan findings should be pursued with an upper endoscopy if no obvious cause is evident. Abnormal CT scan was not found to be associated with malignancy in this study.