Factors Associated with Clinically Significant Extrinsic Compression on Gastroduodenal Endoscopy

Abstract

Background: Although clinicians frequently encounter incidentally detected gastroduodenal extrinsic compressive lesions (GDECLs) on upper gastrointestinal endoscopy (UGE), the optimal management approach for GDECLs has not been fully established. This study aimed to stratify and identify important factors associated with clinically significant GDECLs that require regular follow-up or further treatment.

Methods: Between June 2007 and December 2015, a total of 73 patients with suspected GDECLs on UGE at Kyung Hee University Hospital at Gangdong were identified and studied retrospectively. After the final diagnosis, patients were divided into the following two groups: clinically significant GDECLs, which requires regular follow-up or further treatment, and clinically non-significant GDECLs.

Results: Among 73 GDECLs, 23 (31.5%) lesions were classified as clinically significant GDECLs and 50 (68.5%) as clinically non-significant GDECLs. In multivariate analysis, clinical and endoscopic parameters that were independently associated with clinically significant GDECLs included older age (≥ 60 years), large size (≥ 4 cm) of extrinsic compression, previous history of intra-abdominal malignancy, and symptoms of abdominal distension (all p < 0.05).

Conclusions: Several clinical and endoscopic parameters showed significant association with the identification of clinically significant GDECLs on endoscopy. These predictive factors might be useful in determining whether to perform further diagnostic work-up in patients with GDECLs.

Keywords: Endoscopy; Extrinsic compression; Subepithelial lesion.