Is abdominal CT useful for the management of patients with severe acute colitis complicating inflammatory bowel disease? A study in 54 consecutive patients. (3rd April 2017)

• Record Type: Journal Article
• Authors: Mege, D.; Monsinjon, M.; Zappa, M.; Stefanescu, C.; Treton, X.; Maggiori, L.; Bouhnik, Y.; Panis, Y.
• Is Part Of: Colorectal disease. Volume 19:Number 4(2017)
• Page Start: O97
• Page End: O102
• Publication Date: 2017-04-03
• Subjects: CT -- inflammatory bowel disease -- severe acute colitis -- surgery -- toxic megacolon; Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; 616.34
• DOI: 10.1111/codi.13640
• Languages: English
• ISSNs: 1462-8910

Abstract

Abstract: Aim: To evaluate the contribution of CT for the management of patients with severe acute exacerbation of colitis (SAC) complicating inflammatory bowel disease (IBD); in particular, its contribution to surgical decision making. Method: All patients who were admitted to our institution for SAC complicating IBD were divided into two groups: group A (those who received surgical treatment); and group B (those who received medical treatment). Admission CT results were compared between groups. Results: From 2006 to 2015, 54 patients [26 male; median age 39 (17–71) years] presenting with SAC were placed in either group A ( n = 41; 76%) or group B ( n = 13; 24%). Surgical patients in group A more frequently had altered general status (50 vs 17%; P = 0.01). Physical examination, Lichtiger score, endoscopic findings and laboratory results were similar between the groups. There was no significant difference in CT data between the groups with respect to extent of the colitis (pan‐colitis in 54 and 69%, respectively, P = 0.35), median colonic thickness [10 (4–16) vs 8 (6–11) mm, P = 0.15], target enhancement (88 vs 77%, P = 0.38) and occurrence of toxic megacolon (2 vs 0%). Conclusion: Admission CT is not helpful in surgical decision making in SAC.