AB019. SOH22ABS183. Investigation and endoscopic findings for CT reported colitis
Colorectal Session

AB019. SOH22ABS183. Investigation and endoscopic findings for CT reported colitis

Amy Edwards Murphy1,2, Helen Earley1,2, Ben Creavin1,2, Fiachra Cooke1,2, Peter McCullough1,2, Peter Neary1,2

1Department of Academic Surgery, University Hospital Waterford, Waterford, Ireland; 2Department of Academic Surgery, University College Cork, Cork, Ireland

Background: Colitis is a clinical diagnosis made in conjunction with laboratory results, endoscopic and histological findings. There are patients who present with acute abdominal pain and a CT is arranged to investigate possible surgical pathology. Colitis is occasionally identified which may warrant further investigation to classify aetiology and influence management.

Methods: Review of all adult patients who have a computerized tomography abdomen pelvis (CTAP) with reported colitis, features suggestive of colitis with recommended endoscopic correlation from 01/01/2020–31/12/2020.

Results: National Integrated Medical Imaging System (NIMIS) search produced 87 such CTs. Age range 16–94 years (average 60 years). There was 23 excluded following review where the word colitis was used for ‘no evidence of colitis’. Three patients had known inflammatory bowel disease (IBD) and one had known colitis at time of imaging. A small number of reports were specifically suggestive of IBD, typhlitis, pancolitis and enterocolitis. Stool cultures for clostridium difficile were not performed in 44% of patients. Those screened had 11.5% positive. Molecular Enteric Screening was not performed in 42%. Those screened had 5.5% positive. There was no endoscopy for 65% of patients. Of those scoped, 57% had positive relevant findings including ulcerative colitis (UC), Crohn’s and nonsteroidal anti-inflammatory drug (NSAID) induced IBD. Only 9.5% had a normal scope.

Conclusions: With increasing use of CT in the investigation of abdominal pain, it is important to rationalise the use of resources for incidental findings of colitis. Stools cultures proved to be a high yield investigation. Stool cultures should be performed for all incidental findings suggestive of colitis. If these are negative, the patient should proceed to endoscopy.

Keywords: Colitis; stool culture; colonoscopy; CT scan; incidental findings

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-22-ab019
Cite this abstract as: Edwards Murphy A, Earley H, Creavin B, Cooke F, McCullough P, Neary P. AB019. SOH22ABS183. Investigation and endoscopic findings for CT reported colitis. Mesentery Peritoneum 2022;6:AB019.

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