TTP1.09 Rationalising Endoscopy After Acute Diverticulitis

Aims Acute diverticulitis (AD) is a common emergency presentation, requiring CT to support diagnosis. Given the risk of underlying malignant pathology, ACPGBI recommends luminal assessment for complicated diverticulitis only. This audit assesses adherence to these key recommendations in practice. Methods Data was extracted on all AD admissions during the 1 year period, identified using ICD codes K57.2 and K57.3, excluding patients with existing colorectal cancer diagnoses. Data was collected on the disease complexity, referral outcomes, endoscopy outcomes and waiting times. Results 219 cases were audited. 14% did not receive CT scans and 21% were treated for AD without radiological evidence. In confirmed AD (n=139), 53% were referred for endoscopy unnecessarily or not referred when an endoscopy was indicated. 23% of endoscopies were abandoned, 26% found polyps, and 6% found cancer. Median time to endoscopy was 108 days, exceeding the recommended benchmark of 42 days. Conclusions The necessary radiological evidence is not consistently requested to diagnose and categorise AD. Unnecessary endoscopy practice is frequent following episodes of uncomplicated AD, and necessary referrals are not always made in cases of complicated AD. This has implications for resource use, and patient risk. There is a need to clearly disseminate these recommendations.