Does CT Influence the Decision to Perform Colectomy in Patients with Severe Ulcerative Colitis?

Abstract

PurposeThe 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). MethodsPatients with SAC admitted to a single hospital between 2002 and 2007 were reviewed. The criteria for SAC were ≥6 bloody bowel movements per day plus fever >37.8°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. ResultsNinety-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. ConclusionCT has a minor impact on the decision to perform colectomy in patients with severe acute ulcerative colitis.