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

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