TTP2.10 Assessing Adherence to ACPGBI Guidelines for Acute Diverticulitis Follow-Up: A Trust-wide Evaluation

Background Acute diverticulitis (AD) is a common surgical condition classified as complicated or uncomplicated based on severity. Imaging findings, including colonic wall thickening, can mimic malignancy. The incidence of colonic neoplasia in complicated AD ranges from 7.8% to 10.9%, necessitating interval colonoscopy following an episode. The Association of Coloproctology of Great Britain and Ireland (ACPGBI) provides guidelines to standardize follow-up practices. Aim To assess adherence to ACPGBI guidelines for AD follow-up in patients managed conservatively within Cwm Taf Morgannwg University Health Board (CTM UHB). Methods The first audit cycle analyzed AD admissions at Princess of Wales Hospital (POWH) over 18 months to assess guideline adherence. Following this, a multifaceted intervention introduced updated local guidelines, educational posters, and teaching sessions. A second audit cycle included data from both POWH and Prince Charles Hospital (PCH) and was reviewed in a Trust Audit Meeting. Results In the first cycle at POWH, 55.6% of complicated AD cases had follow-up endoscopy, with 100% adherence for suspected malignancy. However, 60% of uncomplicated AD cases underwent unnecessary endoscopy. After intervention, the second cycle showed improvement: at POWH, follow-up endoscopy increased to 62.5% in complicated AD, and unnecessary endoscopy for uncomplicated AD decreased to 27.3%. At PCH, 57.1% of complicated AD cases and 33.3% of suspected malignancies had follow-up, while 66.7% of uncomplicated AD cases underwent unnecessary endoscopy. Conclusions Adherence improved but varied across sites. Efforts should focus on minimizing unnecessary investigations while ensuring proper follow-up for complicated and malignant cases.