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News

Abdominal CT on the management of IBD in the emergency department

The latest issue of the Alimentary Pharmacology & Therapeutics investigates the impact of abdominal computed tomography in a tertiary referral center emergency department on the management of patients with inflammatory bowel disease.

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Although exposure to diagnostic radiation may be associated with increased risk of malignancy, the use of abdominal CT in the last decade has increased for patients in the emergency department.

Dr Israeli and colleagues from Israel examined the impact of abdominal CT ordered in the emergency department on management of patients with inflammatory bowel diseases, as well as to quantify the cumulative effective dose of radiation received by these patients.

The research team analyzed a total of 152 patients with Crohn's disease, and 130 patients with ulcerative colitis that presented to the emergency department in a tertiary center between 2009 and 2011.

For patients that had an abdominal CT, chart review assessed if the ACT findings changed clinical management.

Abdominal CT use was 49% for Crohn's disease
Alimentary Pharmacology & Therapeutics

CED of diagnostic radiation was calculated for all imaging studies between 2006 and 2012.

Abdominal CT use was 49% for Crohn's disease, and 19% for ulcerative colitis.

Abdominal CTs with findings of penetrating/obstructive disease were 35% for Crohn's disease.

The doctors found urgent non-inflammatory bowel diseases-related diagnoses in 13% for Crohn's disease, and 28% for ulcerative colitis.

Abdominal CT caused a change in management in 81% of Crohn's disease, and 69% of ulcerative colitis patients.

The team found that mean cumulative effective dose from diagnostic radiation was 77 mSv for Crohn's disease, and 67 mSv for ulcerative colitis.

The researchers observed that the cumulative effective dose for the 80-month period exceeded 75 mSv in 35% and 36%, respectively.

Dr Israeli's team concludes, "Although abdominal CT often changes management of inflammatory bowel diseases patients in the emergency department, this population carries a very high-risk of radiation exposure."

"Efforts should be made to decrease this risk by development of low-radiation protocols, and wider use of MRI/ultrasound."

Aliment Pharmacol & Ther 2013: 38(5): 513–521
11 September 2013

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