SAGES Magazine

THE SOUTH AFRICAN GASTROENTEROLOGY REVIEW 2021 | VOLUME 19 | ISSUE 2 | 43 Clinicopathological spectrum of ulcerative colitis at a quaternary referral hospital in KwaZulu-Natal, South Africa Introduction The chronic nature and associated complications of ulcerative colitis (UC) may result in a significant decline in the quality of life of patients. Aim To describe the demographics and disease course of UC in KwaZulu-Natal, South Africa Methods A retrospective chart review of patients diagnosed with IBD attending Inkosi Albert Luthuli Central Hospital from 2002 to 2019 was done. Demographic data, clinical variables and disease outcomes of patients with UC were extrapolated from the password-protected hospital information management system and analysed using Microsoft excel. Patients with Crohn’s Disease and inflammatory bowel disease unclassified were excluded. Data collected included demographics, clinical presentation, management and follow-up. Data was extrapolated from the password-protected hospital information management system and analysed using Microsoft excel. Ethical approval was obtained from the Biomedical Research Ethics Committee of the UKZN (Ref.:BE502/16). Results Four hundred and ten charts with a diagnosis of IBD were identified. UC was diagnosed in 262 patients (64%), including 157 Indian (60%), 68 Black (26%), 27 White (10%), and nine Coloured (3%).M:F ratiowas 1:1.1.Median age at diagnosis was 33 years (IQR 23-45). Most patients presented with diarrhoea (102, 39%); extensive colitis (E3: 154; 59%) and anaemia 60 (23%). Forty-two (16%) had extraintestinal manifestations (EIMs). Most patients were treated with aminosalicylates (228; 87%) and immunomodulators (186; 71%). Abdominal surgery was required in 50 (19%) most commonly for failed medical therapy (19; 7%) and acute severe colitis (16; 6%). Clinical remission was recorded in 113 (54%) and death occurred in 12 (5%) at median follow-up of 59 months (IQR 14-114). Conclusion Patients with UC were mainly Indian and Black. Age at diagnosis was young and gender distribution was equal. EIMs were seen in 16% and surgical referral rate was 19%. Clinical remission was achieved in the majority. C Gounden 1 , VG Naidoo 1 , KA Newton 1 , TE Madiba 2 Department of Gastroenterology, Inkosi Albert Luthuli Central Hospital, University of KwaZulu-Natal 1 , Gastrointestinal Cancer Research Group, Department of Surgery, University of KwaZulu-Natal 2 Introduction: CT scanning is widely available and thus frequently used in the diagnostic work-up of abdominal complaints. Colonic wall thickening is often reported on CT scans and poses a dilemma to clinicians whether colonoscopy is required. Previous studies have shown that CT colonic wall thickening has a correlation of 69% with abnormal colonoscopic findings.We aimed to correlate CT findings of colitis with findings on colonoscopy. Methods: A retrospective review of all abdominal CT scans performed during 2019 was conducted. Those with “colitis” on their imaging were included. Analysis of demographics, endoscopy reports and folders was undertaken to assess correlation with endoscopy findings. Results: 69 patients had colitis / “colonic wall thickening” on CT scan. 51% were males, mean age was 46 years (SD±15.7). The median time interval between imaging and colonoscopy was 5 days (IQR=3-13). Primary indications for CT scan were abdominal pain (56.5%), diarrhoea (20.2%), looking for sepsis (11.5%) and rectal bleeding (2.9%). Most common sites of radiological disease were pancolitis (24.6%), recto-sigmoid (23.1%) and ascending colon (18.9%). 55% proceeded to colonoscopy, where colitis was noted in 63.1% of cases. The most common locations of endoscopic colitis were recto-sigmoid (41.3%) and a pancolitis (31%). There was no correlation between disease location radiologically and endoscopically (r=0.34, p=0.065). Similarly, there was no corelation between CT indication and endoscopic colitis (r=0.038, p=0.891) or time of colonoscopy (r=0.092, p=0.500). Overall 26% of the cohort had Inflammatory Bowel Disease. Conclusion: Endoscopists are often faced with the dilemma of whether to proceed with colonoscopy on patients with a radiological finding of colitis. This data showed no correlation between CT indication or findings with colonoscopic findings. Therefore, although this is a small study, the need for colonoscopy should be individualized. Correlation of findings of colitis on CT compared to colonoscopy T Khan, S Moosa, M Setshedi Division of Gastroenterology, University of Cape Town, Groote Schuur Hospital SAGES