Abdominopelvic CT-scan in emergency departments for patients with suspected complications of Crohn’s disease: a single tertiary center experience

• Published in: BMC emergency medicine 2021-10, Vol.21 (1), p.1-113, Article 113
• Main Authors: Verdalle-Cazes, Mikael, Charpentier, Cloé, Benard, Coralie, Joly, Luc-Marie, Dacher, Jean-Nicolas, Savoye, Guillaume, Savoye-Collet, Céline
• Format: Article
• Language: English
• Subjects: Abdomen; Abdominopelvic CT-scan; Abscesses; Analysis; Chronic illnesses; Complications; Computed tomography; Crohn's disease; CT imaging; Disease; Emergency department; Emergency medical care; Emergency medical services; Emergency service; Fistula; Gastroenterology; Gastrointestinal diseases; Genotype & phenotype; Hospitalization; Hospitals; Human health and pathology; Hépatology and Gastroenterology; Immunosuppressive agents; Intestinal obstruction; Life Sciences; Localization; Multivariate analysis; Patients; Phenotypes; Signs and symptoms; Statistical analysis; Steroids; Surgery
• ISSN: 1471-227X; 1471-227X
• DOI: 10.1186/s12873-021-00512-5

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. Keywords: Crohn's disease, Emergency department, Abdominopelvic CT-scan