AB059. SOH25_AB_008. Evaluating the clinical utility of computerised tomography as an adjunct tool in screening patients undergoing direct access endoscopy

Background: Direct access endoscopy (DAE) is a patient-focused rapid diagnostic modality for investigating gastrointestinal disorders. Computerised tomography (CT) as an adjunct may represent a promising screening tool in detecting other synchronous pathologies. This study aimed to evaluate the efficacy of combined CT and DAE in detecting significant incidental disorders.

Methods: A retrospective study was performed over a 7-year eligibility period (May 2017–July 2024). Incidental findings (IF) on CT were categorised into a four classifications as described by Krocze et al.; Category 1—findings requiring urgent follow-up or intervention within 3 months, Category 2—findings requiring a follow-up within the next 3–6 months, Category 3—findings with no immediate consequence but requiring surveillance or of potential relevance in the future, and Category 4—findings that were deemed clinically insignificant.

Results: Overall, 592 patients were included. Of these, 79 had findings classified as Category 1 (13.34%), 54 patients had Category 2 findings (9.12%), 80 patients had Category 3 findings (13.51%) and 327 patients had Category 4 findings (55.24%). Only 52 patients (8.78%) had no IF. In total, 2,884 IF were identified, of which 89 were classified as Category 1 findings (3.09%), 64 were Category 2 (2.22%) and 122 were Category 3 (4.23%).

Conclusions: This study demonstrated a high IF identification rate in patients undergoing DAE. Importantly, 13.34% of the patients had Category 1 asymptomatic findings which required urgent attention. This supports the routine utility of CT as an adjunct with DAE to facilitate the earlier detection of asymptomatic significant disorders.

Keywords: Asymptomatic pathologies; computerised tomography (CT); direct access endoscopy (DAE); incidental findings (IF); screening tool