PP0699 Evaluating the underlying aetiology in patients with reported colitis on computed tomography imaging

Introduction: Computed tomography (CT) is a common modality usedto assess patients who present acutely with gastrointestinal symptoms.1The term colitis refers to the thickening of the colonic wall 2 and is oftendescribed in CT reports. Causes of colitis are commonly classified into in-fectious, inflammatory and ischaemic colitis.3Although there are some radiological features that are helpful in suggest-ing a specific diagnosis,4 determining the underlying aetiology of colitisoften requires correlation with clinical history, laboratory results includ-ing stool cultures and endoscopic evaluation.1There is currently limited literature on the prevalence of the different aeti-ologies in patients with colitis reported on CT. 3Identification of the underlying aetiology allows for specific managementof patients as treatment options differ depending on the underlying cause. Aims & Methods: The aim of this study is to identify the aetiology of colitisin patients with reported colitis on CT imaging.A retrospective review of CT reports and patient case notes was per-formed. A text search through our radiology system (CRIS) was used toidentify patients with CT reported colitis during their inpatient admission.Patients with known Inflammatory bowel disease (IBD), colorectal canceras well as outpatient CT reports were excluded.Following identification of our patient cohort, we reviewed their clinicalnotes as well as laboratory, stool and endoscopic results to determine theunderlying aetiology of their colitis. Results: A total of 138 patients with colitis reported on CT imaging wereincluded. 98 patients (71.0%) had a stool culture sent during their admis-sion whilst 83 patients (60.1%) underwent endoscopic evaluation with aflexible sigmoidoscopy (n=49, 59.0%) or colonoscopy (n=34, 41.0%). In 35patients (42.2%) there were no significant abnormalities found endoscop -ically.74 patients (53.6%) were thought to have infectious colitis with mainpathogens including Campylobacter spp. in 19 patients (25.7%), Clost-ridiodes difficile in 11 patients (14.9%) and Salmonella spp. in 1 patient(1.4%). 4 patients (5.4%) had endoscopic features of infectious colitis. 39patients (52.7%) patients were suspected to have infective colitis fromclinical history and laboratory results.25 patients (18.1%) had ischaemic colitis either confirmed endoscopically(n=11, 44.0%) or through clinical history and CT features (n=14, 56.0%).Endoscopically, 6 patients (4.3%) had features compatible with IBD, 2 patients (1.4%) with lymphocytic colitis and 1 patient (0.7%) with an adeno -carcinoma. 15 patients (10.9%) had diverticulosis.C-reactive protein (CRP) was higher in patients with infectious colitis(mean of 141.4 mg/L) and lower in patient with ischaemic colitis (mean of108.6 mg/L). Albumin and haemoglobin levels were highest in those withinfectious colitis (mean of 33.4 g/L and 135.5g/L respectively) and lowestin patients with IBD (mean of 26.8 g/L and 108.5g/L respectively). Conclusion: CT reported colitis was of infectious aetiology in 53.6% of pa-tients, ischaemic in 18.1% and inflammatory in 4.3%. Laboratory resultssuch as haemoglobin and albumin levels can be helpful in determiningaetiology.Despite CT features suggestive of colitis, 42.2% of endoscopic evaluationrevealed no significant abnormality. CT findings of colitis should thereforebe correlated with clinical history, stool results and endoscopic evalua-tion when determining the underlying aetiology. (Full abstract freely available on publisher's site. Click DOI below. PDF pages 430-431, printed pages 1232-1233)

Citation

Chan S. & Shaw I. (2025). PP0699 Evaluating the underlying aetiology in patients with reported colitis on computed tomography imaging. United European Gastroenterology Journal, 13(Supplement_8), 1232. https://doi.org/10.1002/ueg2.70036

DOI

10.1002/ueg2.70036

URI

https://hdl.handle.net/20.500.14709/1156

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Free access to article on publisher's webpage. Click DOI.