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

Year 2021, , 301 - 307, 31.12.2021

Mehmet Alperen Avcı

https://doi.org/10.30565/medalanya.924320

Abstract

Aim: Abdominopelvic computed tomography is commonly used for delineating the causes of abdominal pain. While its popularity has increased, the rate of non-specific 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.

Methods: 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.

Keywords

endoscopy,, colonoscopy,, abdominal computed tomography,, Wall thickening,

Gastrointestinal sistemin endoskopik bulguları ve tomografi bulguları ile ilişkisi

Abstract

Amaç: Abdominopelvik bilgisayarlı tomografi, karın ağrısı nedenlerini belirlemek için yaygın olarak kullanılmaktadır. Tomografinin popülaritesi artarken gastrointestinal duvar kalınlaşması gibi nonspesifik bulguların oranı da artmıştır. Duvar kalınlığı artışının, endoskopik değerlendirmede patolojik bir bulguyu tahmin edip etmediğini belirlemeyi amaçladık.

Yöntemler: Bu retrospektif çalışma, 2019 yılında merkezimizde endoskopik veya kolonoskopik değerlendirme yapılan ve bu incelemeden önceki bir ay içinde abdominopelvik tomografi yapılan erişkin hastalar üzerinde yapılmıştır. Tomografi taramaları sırasında hastaların mide veya kolon duvar kalınlıkları ölçüldü. Bu hastaların endoskopi veya kolonoskopi sonuçları alınarak duvar kalınlıkları ile korelasyonları incelenmiştir.

Bulgular: Çalışma 647 hastayı içeriyordu. 106'sına (%16.38) endoskopi yapılırken, 541'ine (%83.62) kolonoskopi yapıldı. Endoskopik biyopsiler 101 hastada (%95,3) malign, 5 (%4,7) hastada benign idi. BT kesitlerinde 93 (%87.7) hastada kalınlaşmış duvar görüldü. Duvar kalınlık artışı olan ve olmayan hastaların karşılaştırılması, malignite oranları açısından farklılık göstermedi.BT kesitlerinin 506'sında (%93,5) kolon duvar kalınlığında artış saptandı. 19 (%3,5) hastada normal veya benign kolonoskopik biyopsi bulguları rapor edildi. 456 (%84,2) hastada adenokarsinom tespit edildi. Duvar kalınlık artışı olan ve olmayan hasta gruplarının karşılaştırılması malignite oranları açısından anlamlı bir farklılık ortaya koymadı.

Sonuç: Tomografi gibi tek bir test kullanıldığında tanısal ve prediktif doğruluk sınırlı olduğundan tomografi taramalarında gastrointestinal duvar kalınlaşması olan hastalarda endoskopik-kolonoskopik değerlendirmelerİ de ek olarak yapılmalıdır.

Keywords

Endoskopi, Kolonoskopi, Duvar Kalınlığı, Bilgisayarlı Tomografi

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