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

Abstract : 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.
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https://www.hal.inserm.fr/inserm-03373362
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Submitted on : Monday, October 11, 2021 - 2:36:03 PM
Last modification on : Tuesday, October 19, 2021 - 5:34:13 PM

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Mikael Verdalle-Cazes, Cloé Charpentier, Coralie Benard, Luc-Marie Joly, Jean-Nicolas Dacher, et al.. Abdominopelvic CT-scan in emergency departments for patients with suspected complications of Crohn’s disease: a single tertiary center experience. BMC Emergency Medicine, BioMed Central, 2021, 21 (1), pp.113. ⟨10.1186/s12873-021-00512-5⟩. ⟨inserm-03373362⟩

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