Is Abnormal Radiology A Good Predictor Of Endoscopic Findings?

Aims The aims of this study were to assess the correlation between abnormal imaging and endoscopic findings.

Methods A retrospective descriptive study was performed. All patients referred with abnormal radiology as the indication for lower GI endoscopy in Louth County Hospital (LCH) between 2013 and August 2020 were included.

Data, including; patient demographics, the modality of imaging, results of imaging, indication for endoscopy, and results of endoscopy were collected using electronic patient records.

Endoscopic findings were compared with radiology reports.

Results A total of 209 lower GI endoscopies, (172 colonoscopies and 37 sigmoidoscopies) were performed in LCH between 2013 and August 2020 for the indication of abnormal radiology, 51 % (n = 108) were male. The mean interval from imaging to colonoscopy was 86.3 days (Range 13-218 days). 81 % (n = 170) of imaging modalities employed were CT scans. The mean interval from imaging to sigmoidoscopy was 128 days (range 11 days to 823 days). CT Colon accounted for 51 % (n = 19) of the imaging modalities employed.

In Our patient cohort 71 % of endoscopic findings correlated with radiology.

Conclusions The most common abnormality on radiology referred for lower GI endoscopy was diverticulitis. A tumour was identified endoscopically in one of these patients. No other suspicious endoscopic findings were detected. The need for endoscopy post an episode of uncomplicated diverticulitis without suspicious features is questionable. Current practice guidelines do not recommend routine endoscopy post uncomplicated diverticulitis. In some studies, the risk of advanced neoplasia post uncomplicated diverticulitis is equivalent to the risk of colorectal cancer in the general population.

59 % of radiology findings suggestive of thickening, colitis, or strictures correlated with endoscopic findings. In the appropriate clinical context, not all patients with such features on radiology require endoscopic and histological diagnoses.

Further assessment is recommended to identify specific imaging abnormalities that benefit from endoscopy allowing appropriate use of our limited resources.

Citation Adam M, Conlon C, Doing S et al. eP129 IS ABNORMAL RADIOLOGY A GOOD PREDICTOR OF ENDOSCOPIC FINDINGS?. Endoscopy 2021; 53: S139.

Publication History

Article published online:
19 March 2021