Abstract
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. 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. 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). 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.
Highlights
Increased wall thickness anywhere in the gastrointestinal tract is an important finding that should not be disregarded
Increased wall thickness may have many causes; benign or malignant neoplasms, inflammation, and postoperative changes are the most common. Most of these can be detected by computed tomography (CT).[1,2]
The objective of this study was to evaluate the endoscopy findings of patients with findings of increased wall thickness in the gastrointestinal tract on CT performed for various complaints
Summary
Increased wall thickness anywhere in the gastrointestinal tract is an important finding that should not be disregarded. Increased wall thickness may have many causes; benign or malignant neoplasms, inflammation, and postoperative changes are the most common Most of these can be detected by computed tomography (CT).[1,2] CT may not be sufficient to provide the full explanation. Wall thickening is often noted in the digestive tract during abdominal imaging in patients without gastrointestinal complaints. When this finding is encountered, the endoscopist has a significant role. 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.
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