686 National Audit Assessing the Imaging of Acute Pancreatitis at Mater Dei Hospital, Malta

Aim The aim of this audit is to assess the imaging of acute pancreatitis (AP) in patients admitted to Mater Dei Hospital, Malta using the Royal College of Radiologists (RCR) recommendations as standard. Method Retrospective data of patients admitted with AP between 1/1/22 and 31/12/22 was collected. Timing of initial CT (at least 72 hours after symptom onset), CT report inclusion of prognostic factors, and timing of ultrasonography (US) of the gallbladder (within 24 hours of diagnosis) were analysed. Results 187 patients were included in this study. 99 patients were investigated with a CT scan during their admission, with only 25.3% of these patients being scanned at least 72 hours after developing symptoms. 74.7% of CTs were done within 72 hours of symptom onset. 47.3% of patients who had an early CT received a further CT or MRCP scan in the same admission. 24.2% of CTs mentioned all 3 key prognostic factors outlined in the RCR recommendations: pancreatic necrosis, free intraperitoneal fluid, and peripancreatic fat stranding. Only 20.2% of patients had an US examining the gallbladder within 24 hours of diagnosis. Conclusions Results show that CT scans are being performed too early in the clinical course of AP, with little reliance on US as a quick, non-invasive, and inexpensive first-line scan. Early CTs in AP generally do not alter management and risk missing complications. Our aim is to improve local practices through multiple educational sessions addressed towards emergency doctors, general surgeons, and radiologists.