Diagnostic Yield of Endoscopy after Upper Gastrointestinal Tract Abnormality Found on Computed Tomography

Abstract

Introduction: The aim of this study was to evaluate the diagnostic yield of endoscopy after upper gastrointestinal (GI) tract abnormality was found on computed tomography (CT) scan. Methods: Retrospective identification of upper GI endoscopy performed with an indication of “abnormal CT” in a 3-year period. Cases were grouped according to clinical suspicion of underlying GI tract pathology (“expected” or “unexpected”). CT report findings were categorised into one of four categories: dilatation, lymphadenopathy, mass lesion or mural thickening and compared with the main endoscopic finding. Where available, histology was included. Results: Of 96 patients undergoing upper GI endoscopy after abnormal CT, 14 (15%) had normal examinations. 17 (18%) of 96 patients were found to have an underlying neoplasm (adenocarcinoma, squamous cell carcinoma or lymphoma) of which seven were unexpected clinically. Six (6%) of 96 patients were found to have Barrett’s oesophagus. In five (83%) of six patients with Barrett’s, there was no clinical suspicion for GI tract pathology. A correlative endoscopic abnormality was found in five (45%) of 11 masses where GI pathology was expected compared with eight (40%) of 20 masses when unexpected. Where thickening was reported on CT, a correlative endoscopic abnormality was found in 14 (63%) of 22 patients with expected GI tract pathology compared with 13 (62%) of 21 patients when unexpected. Conclusions: The diagnostic yield of endoscopy for significant GI tract pathology performed after CT is high and merits further investigation.