Abstract No. 576 Factors influencing cumulative radiation dose for percutaneous intra-abdominal abscess drainage in patients with inflammatory bowel disease

Abstract

Patients with inflammatory bowel disease (IBD) are at risk for penetrating disease complications and intra-abdominal abscesses requiring CT-guided drainage. These patients are at baseline risk of high cumulative radiation exposure from diagnostic imaging, which may be exacerbated by CT-guided drainage. This study aimed to determine the radiation dose associated with percutaneous drainage and follow-up in the setting of IBD and identify risk factors associated with high exposure. An IRB-approved single-center retrospective study was performed to identify patients with IBD who underwent abscess drainage over a five-year period (2013-2018). An episode of drainage was defined from drain placement to removal, with all procedures and diagnostic CT scans included in the cumulative radiation dose. Radiation dose was reported by a monitoring database, Radimetrics (Whippany, NJ). Patients were divided into cohorts based on a cumulative effective dose of 50 mSv. Statistical analysis was performed with GraphPad Prism 8 (La Jolla, CA). Patient demographics (n = 40) are reported in Table 1. The mean cumulative effective dose for the percutaneous drainage episodes was 47.50 mSv. The mean total duration of drainage episodes was 68.7 days, with an average of 4.48 CT scans or repeat interventions during that period. Patients with a total dose greater than 50 mSv (group A) required higher number of follow-up visits compared to patients with less than 50 mSv (group B) (6.9 vs. 3.5, P = 0.003). Group A patients were more likely to require drain upsize (54% vs. 13%, P = 0.01) or repeat drain placement (63% vs. 24%, P = 0.03) after initial drainage compared to group B patients. Group B patients had significantly higher number of drains placed at initial drainage compared to group A (1.8 vs. 1.2, P = 0.002). Intra-abdominal abscess drainage may be associated with significant cumulative radiation exposure. Drain upsizing, fewer initial drains, and repeat drain placement were associated with higher dose, which demonstrates the importance of catheter caliber selection and catheter positioning at the time of initial drainage to potentially reduce overall radiation exposure.Table 1Male:female ratio20:20Average age (years, mean ± SD)42.83 ± 16.65Crohn’s disease:ulcerative colitis33:7Drainage of postoperative complication24/40 (53%) Open table in a new tab