EP.TU.883Improving diagnosis in all male patients admitted with right iliac fossa pain. (28th October 2021)

• Record Type: Journal Article
• Authors: Ballance, Laura; Withers, Chloe; Nair, Dheepa; Galloway, Simon
• Is Part Of: British journal of surgery. Volume 108:Supplement 7(2021)
• Publication Date: 2021-10-28
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znab311.110
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Background: Right iliac fossa pain is a common presenting complaint in males. Ultrasound is a cheap non-invasive investigation, yet results can be non-diagnostic. CT is becoming more accessible and available for patient assessment. Aim: Our primary aim is to estimate how many unnecessary US scans are gained prior to CT imaging, thereby delaying surgery, increasing cost and increasing length of stay (LOS). Method: We conducted a retrospective analysis of all male patients over the age of 16 admitted to a single unit with RIF pain over 12 months. Outcome and length of stay was recorded. Results: 162 male patients were admitted to a single University teaching hospital between 2017 and 2018. 33% (n = 53) of patients having an US scan require further imaging, 40% ( n = 21 ) of these had a surgical pathology, 80% (n = 17) of these requiring appendicectomy. Patients (n = 39) who had an initial CT scan subsequently requiring surgery length of LOS 3.6 days compared with US imaging with additional imaging requiring surgery ( n = 17) LOS 5.8 days. Conclusion: Evaluation of practice of males over the age of 16 shows that US is frequently non diagnostic, requiring further investigation with CT or MRI. Imaging initially with CT scan aid diagnosis and decrease length of stay. An education steering committee of surgical trainees, consultants and radiographers has been created to adapt practice in our centre through continued education and training.