T1227 Outcomes of CT Colonography When Used to Investigate Iron Deficient Anaemia (IDA)
| Autor: | Robert P. Willert, Andrew Mcpartlin, Lolita Chan, Javaid Iqbal, Tuheen Huda |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
Postmenopausal women Hepatology medicine.diagnostic_test business.industry education Gold standard Gastroenterology Colonoscopy medicine.disease digestive system diseases Diverticulosis hemic and lymphatic diseases medicine Iron deficient Retrospective analysis Rectal tumour Radiology Angiodysplasia business neoplasms |
| Zdroj: | Gastroenterology. 138:S-516 |
| ISSN: | 0016-5085 |
| DOI: | 10.1016/s0016-5085(10)62382-7 |
| Popis: | Introduction: BSG guidelines recommend endoscopic investigation in men and postmenopausal women with IDA but not all are fit enough or wish to pursue this. CT Colonography (CTC) is a widely available alternative modality for colonic imaging in recent years and with increasing use at our institution we audited all CTC's requested and performed in 2008, of which this abstract is a part. Methods: We performed a retrospective analysis of consecutive patients undergoing CTC over twelve months identifying IDA. Results: Of 531 analysed CTC procedures 130 (24.6%) were for the IDA. The average age of patient investigated for IDA was 73.1 years (42 to 93). 24.7% of patients undergoing CTC had a normal appearing colon. Diverticulosis was the dominant finding in 18.4%. Incidental malignancies outside of the colon were found in 7.6% of patients. 11% of patients undergoing CTC went on to have a colonoscopy. CRC was suspected radiologically in 7.7% (10 patients) and further direct visualisation was recommended. Three patients went on to have colonoscopy, with a diagnosis of CRC refuted in one case. Polyps were identified on CTC in 15.4% (20 patients). Of the 8 patients with polyps >9mm only 6 cases were further investigated with colonoscopy. Polyps were confirmed in five cases with one finding of a benign rectal tumour. Conclusion: IDA is a common indication for CTC accounting for a quarter of all referrals. Diverticulosis was the commonest CTC finding but is unlikely to be the underlying cause of IDA in most of those patients and the 25% of patients with normal CTC may still have a colonic cause for the IDA such as angiodysplasia which is not seen on CTC. CTC identified a large number of significant extra-colonic abnormalities which then require further investigations (see abstract T Huda et al). The lack of subsequent colonoscopic follow up in over half of the 23% found to have suspected polyps or CRC is a concern and may reflect a greater than average patient frailty in the CTC imaging group (see abstract L Chan et al), but this questions whether the CTC showed have been done initially. Colonoscopy should remain the gold standard for colonic investigation in IDA. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|