472 An Audit on the Optimal Timing of Imaging in Acute Pancreatitis

Abstract

Abstract Aim Acute pancreatitis (AP) is an inflammatory process of the pancreas with varied aetiology, commonly gallstone disease (50%) and excess alcohol. We aimed to assess the compliance of our trust in diagnosing and imaging against IAP/APA and BSG guidance. Method Patients diagnosed with AP between 05/2022 and 12/2022 were retrospectively collected. We investigated factors based on guidelines including correctly diagnosing AP within 48 hours of admission, adherence to optimal timing for ultrasonography (<24 hours of diagnosis) and CT (within 72-96 hours after onset of symptoms or 48 hours of admission). Results 65 patients were analysed and correct diagnosis within 48 hours was achieved in 90%. The compliance with timing and type of imaging was, unfortunately, extremely low. Only 6.15% of patients had a CT after 48 hours of admission, 29.23% within 72-96 hours after the onset of symptoms and only 17% had ultrasonography within 24 hours of diagnosis. CT was the initial imaging modality for 75% of patients despite it diagnosing pancreatitis secondary to gallstone disease in only 17% of all cases. Conclusions We demonstrated that our trust is proficient at timely diagnosis of AP, however, has poor compliance with both the timing and type of imaging. BSG recommends ultrasonography as initial imaging in suspected AP over CT due to ultrasonography’s low cost, accuracy and sensitivity. Additionally, early CT’s underestimates final disease severity and do not improve outcomes. Improvements to our service can be made by educating staff regarding the current guidelines and working with the trust to increase ultrasonography availability.