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Does CT influence the decision to perform colectomy in patients with severe ulcerative colitis?
Andre da Luz Moreira1, Jon D Vogel, Mark Baker
1Departments of Colon and Rectal Surgery and Abdominal Imaging, Cleveland Clinic, Cleveland, OH, USA.
Purpose:
The purpose of this study was to evaluate the impact of abdominal computerized tomography (CT) on the decision to perform colectomy in patients with severe acute ulcerative colitis (SAC).
Methods:
Patients with SAC admitted to a single hospital between 2002 and 2007 were reviewed. The criteria for SAC were > or =6 bloody bowel movements per day plus fever >37.8 degrees C, pulse >90, or hemoglobin <10.5 g/dL. Study patients were given a SAC score of 2-4 based on these criteria. Clinical and laboratory parameters, medication use, abdominal X-ray, and endoscopic findings in SAC patients who did or did not have an abdominal CT were compared. Chi-squared, Fisher exact test, and Wilcoxon rank sum test were used as appropriate.
Results:
Ninety-two consecutive patients with SAC were evaluated. CT was performed in 26 (28%). The SAC score, laboratory values, abdominal X-ray, and endoscopic findings were similar in patients who did or did not have a CT. Colectomy was performed in 32 (48%) and 10 (38%) patients who did or did not have a CT, respectively (p = 0.4). The CT findings were similar in patients who required colectomy and those who did not require colectomy. In two (8%) of the patients who underwent CT, the CT findings clearly influenced the decision to perform or defer colectomy.
Conclusion:
CT has a minor impact on the decision to perform colectomy in patients with severe acute ulcerative colitis.
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