Abdominopelvic CT-scan in emergency departments for patients with suspected complications of Crohn's disease: a single tertiary center experience.
Abdominopelvic CT-scan
Crohn’s disease
Emergency department
Journal
BMC emergency medicine
ISSN: 1471-227X
Titre abrégé: BMC Emerg Med
Pays: England
ID NLM: 100968543
Informations de publication
Date de publication:
07 10 2021
07 10 2021
Historique:
received:
01
12
2020
accepted:
30
08
2021
entrez:
8
10
2021
pubmed:
9
10
2021
medline:
23
11
2021
Statut:
epublish
Résumé
Crohn's disease (CD) is a chronic disorder with frequent complications. The objective of this study was to assess the predictive factors of finding a complication of CD using abdominopelvic CT-scan in patients with a visit to the emergency department. Patients with at least one visit to the gastroenterology department of our University hospital during the year with a CD were retrospectively included. All visits to the emergency department of the hospital during the follow-up of these patients were identified. A total of 638 patients were included and 318 (49.8%) had at least one visit to the emergency department since the beginning of their follow-up. Abdominopelvic CT-scan was performed in 141 (23.7%) of the 595 visits for digestive symptoms. Only 4.3% of these CT-scans were considered as normal; there was luminal inflammation without complication in 24.8%, abscess, fistula or perforation in 22.7%, mechanical bowel obstruction in 36.9% and diagnosis unrelated to CD in 11.3%. In univariate analysis, stricturing phenotype (OR, 2.48; 95% CI, 1.16-5.29; p = 0.02) and previous surgery (OR, 2.90; 95% CI, 1.37-6.14; p = 0.005) were predictive factors of finding a complication of CD using abdominopelvic CT-scan, whereas no independent predictive factor was statistically significant in multivariate analysis. In CD patients consulting in emergency department, CT-scan examination was performed in 24% of visits for digestive symptoms and complications of CD were found in 60%. Complications were more frequent in patients with stricturing phenotype and previous surgery.
Sections du résumé
BACKGROUND
Crohn's disease (CD) is a chronic disorder with frequent complications. The objective of this study was to assess the predictive factors of finding a complication of CD using abdominopelvic CT-scan in patients with a visit to the emergency department.
METHODS
Patients with at least one visit to the gastroenterology department of our University hospital during the year with a CD were retrospectively included. All visits to the emergency department of the hospital during the follow-up of these patients were identified.
RESULTS
A total of 638 patients were included and 318 (49.8%) had at least one visit to the emergency department since the beginning of their follow-up. Abdominopelvic CT-scan was performed in 141 (23.7%) of the 595 visits for digestive symptoms. Only 4.3% of these CT-scans were considered as normal; there was luminal inflammation without complication in 24.8%, abscess, fistula or perforation in 22.7%, mechanical bowel obstruction in 36.9% and diagnosis unrelated to CD in 11.3%. In univariate analysis, stricturing phenotype (OR, 2.48; 95% CI, 1.16-5.29; p = 0.02) and previous surgery (OR, 2.90; 95% CI, 1.37-6.14; p = 0.005) were predictive factors of finding a complication of CD using abdominopelvic CT-scan, whereas no independent predictive factor was statistically significant in multivariate analysis.
CONCLUSION
In CD patients consulting in emergency department, CT-scan examination was performed in 24% of visits for digestive symptoms and complications of CD were found in 60%. Complications were more frequent in patients with stricturing phenotype and previous surgery.
Identifiants
pubmed: 34620106
doi: 10.1186/s12873-021-00512-5
pii: 10.1186/s12873-021-00512-5
pmc: PMC8496012
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
113Informations de copyright
© 2021. The Author(s).
Références
Clin Gastroenterol Hepatol. 2014 Oct;12(10):1702-7.e3
pubmed: 24642110
J Crohns Colitis. 2017 Jan;11(1):3-25
pubmed: 27660341
Gut. 2008 Nov;57(11):1524-9
pubmed: 18443021
Lancet. 2012 Nov 3;380(9853):1590-605
pubmed: 22914295
Rev Esp Enferm Dig. 2004 Mar;96(3):174-84
pubmed: 15053732
Am J Gastroenterol. 2012 Nov;107(11):1693-701
pubmed: 22945286
Am J Gastroenterol. 2009 Nov;104(11):2816-23
pubmed: 19690524
Lancet. 2012 Aug 4;380(9840):499-505
pubmed: 22681860
J Clin Gastroenterol. 2011 Jan;45(1):34-9
pubmed: 20679907
Gastroenterology. 2012 Jan;142(1):46-54.e42; quiz e30
pubmed: 22001864
Clin Gastroenterol Hepatol. 2014 Jun;12(6):986-94.e1
pubmed: 24262938
Gastroenterology. 2010 Oct;139(4):1147-55
pubmed: 20637205
Scand J Gastroenterol. 2007 May;42(5):602-10
pubmed: 17454881
Aliment Pharmacol Ther. 2012 Mar;35(5):529-39
pubmed: 22239831
Clin Gastroenterol Hepatol. 2012 Jan;10(1):52-7
pubmed: 21946122
Radiology. 2011 Jan;258(1):164-73
pubmed: 21115875
J Crohns Colitis. 2014 Jun;8(6):504-12
pubmed: 24275204
Am J Gastroenterol. 2010 Feb;105(2):363-70
pubmed: 19809414
Dig Dis Sci. 2015 Apr;60(4):929-35
pubmed: 25064212
Gut. 2006 Aug;55(8):1124-30
pubmed: 16361306
Lancet. 2002 May 4;359(9317):1541-9
pubmed: 12047962
Aliment Pharmacol Ther. 2013 Sep;38(5):513-21
pubmed: 23837741
Emerg Med J. 2014 Jul;31(7):526-532
pubmed: 24473411
Ann Emerg Med. 2006 Jul;48(1):1-8
pubmed: 16781914
Inflamm Bowel Dis. 2013 May;19(6):1179-85
pubmed: 23552763