title: Is abdominal CT useful for the management of patients with severe acute colitis complicating inflammatory bowel disease? A study in 54 consecutive patients.
abstract: OBJECTIVE
  To evaluate the contribution of CT for the management of patients with severe acute exacerbation of colitis (SAC) complicating inflammatory bowel disease (IBD); in particular, its contribution to surgical decision making.
  
  
  METHODS
  All patients who were admitted to our institution for SAC complicating IBD were divided into two groups: group A (those who received surgical treatment); and group B (those who received medical treatment). Admission CT results were compared between groups.
  
  
  RESULTS
  From 2006 to 2015, 54 patients [26 male; median age 39 (17-71) years] presenting with SAC were placed in either group A (n = 41; 76%) or group B (n = 13; 24%). Surgical patients in group A more frequently had altered general status (50 vs 17%; P = 0.01). Physical examination, Lichtiger score, endoscopic findings and laboratory results were similar between the groups. There was no significant difference in CT data between the groups with respect to extent of the colitis (pan-colitis in 54 and 69%, respectively, P = 0.35), median colonic thickness [10 (4-16) vs 8 (6-11) mm, P = 0.15], target enhancement (88 vs 77%, P = 0.38) and occurrence of toxic megacolon (2 vs 0%).
  
  
  CONCLUSIONS
  Admission CT is not helpful in surgical decision making in SAC.
authors.affiliation: Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Clichy, France.
authors.forename: D
authors.initials: D
authors.lastname: Mege
authors.affiliation: Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Clichy, France.
authors.forename: M
authors.initials: M
authors.lastname: Monsinjon
authors.affiliation: Department of Radiology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Clichy, France.
authors.forename: M
authors.initials: M
authors.lastname: Zappa
authors.affiliation: Department of Gastroenterology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Clichy, France.
authors.forename: C
authors.initials: C
authors.lastname: Stefanescu
authors.affiliation: Department of Gastroenterology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Clichy, France.
authors.forename: X
authors.initials: X
authors.lastname: Treton
authors.affiliation: Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Clichy, France.
authors.forename: L
authors.initials: L
authors.lastname: Maggiori
authors.affiliation: Department of Gastroenterology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Clichy, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Bouhnik
authors.affiliation: Department of Colorectal Surgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris VII, Clichy, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Panis
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000066491:Clinical Decision-Making / Q000379:methods*; D003092:Colitis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D003106:Colon / Q000000981:diagnostic imaging* / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: CT; inflammatory bowel disease; severe acute colitis; surgery; toxic megacolon