Evaluation of Endoscopic Findings in Gastrointestinal Tract Wall Thickening Detected on Abdominal Radiological Imaging: A Two-Center Retrospective Descriptive Study

<i>Background and Objectives</i>: The clinical significance of gastrointestinal (GI) tract wall thickening incidentally detected on abdominal imaging remains unclear. This study aimed to examine the relationship between GI tract wall thickening seen in imaging and what is found during endoscopy, as well as to explore how hemoglobin, C-reactive protein (CRP), and albumin levels can help predict the presence of malignancy. <i>Materials and Methods</i>: In this retrospectively designed study, 209 patients were included who were found to have GI tract wall thickening on radiological imaging and underwent endoscopy within 90 days. Endoscopic findings and laboratory data were recorded. Patients were compared based on the presence or absence of malignancy, and a receiver operating characteristic analysis was performed. <i>Results</i>: Malignancy was detected in 8.5% and 10.9% of the upper and lower GI tract cases, respectively. In patients with upper GI tract malignancy, hemoglobin levels were significantly lower and CRP levels were higher (<i>p</i> < 0.001 and <i>p</i> = 0.015, respectively). Similarly, in lower GI tract malignancy, hemoglobin levels were lower (<i>p</i> = 0.033), whereas CRP did not show a significant difference (<i>p</i> = 0.115). Cut-off values were determined as 11.8 g/dL for hemoglobin and 40.75 g/L for albumin, and both were found to have high negative predictive values. <i>Conclusions</i>: GI tract wall thickening detected radiologically is clinically significant and should be further investigated endoscopically. Certain biochemical parameters may aid in ruling out malignancy; however, endoscopy remains essential for definitive diagnosis.