The prevalence of abdominal computed tomography imaging findings in patients with inflammatory bowel disease who present to the emergency department: a systematic review and meta-analysis.

Azward A, Ripstein G, Medawar E, +5 more, McCurdy JD.

Systematic ReviewAbstract only — full text under license

AI summary — for doctors, generated from the abstract only

This meta-analysis found that abdominal CT scans in IBD patients presenting to the emergency department rarely showed serious penetrating complications or non-IBD problems.

What was studied

A systematic review and meta-analysis of 19 studies reporting abdominal CT findings in IBD patients in the emergency department (7,681 CT scans in Crohn's, 858 in UC).

Key findings

Abscess or inflammatory mass: 12% in Crohn's, 3% in UC
Perforation: 3% in Crohn's, 1% in UC
Inflammation: 43% in Crohn's, 48% in UC
Obstruction: 18% in Crohn's, 9% in UC
Non-IBD pulmonary, gastrointestinal, or genitourinary findings were each under 5%

Clinical relevance

The authors suggest more selective CT use in the ED may be warranted for IBD patients, though identifying which patients can safely forgo imaging requires further study.

Who should care

Medical Gastroenterology

Limitations

Pooled observational studies with heterogeneity; fewer data for UC.

Emergency CT scans in IBD patients usually do not find serious complications, which suggests they may be overused.

This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.

Abstract

Background

The diagnostic yield of abdominal computed tomographic (CT) imaging for patients with inflammatory bowel disease (IBD) in the emergency department (ED) is unclear. We aimed to estimate the prevalence of IBD and non-IBD pathologies detected by CT imaging in the ED.

Methods

Multiple databases were systematically searched from inception until April 18, 2025. We included studies that reported abdominal CT findings among IBD patients in the ED. We estimated the prevalence of IBD and non-IBD findings using weighted proportions with 95% confidence intervals (CI). IBD-related findings were reported separately for Crohns disease (CD) and ulcerative colitis (UC), whereas non-IBD findings were pooled for both IBD subtypes.

Results

Overall, 19 studies were analyzed. Among patients with CD (15 studies; n = 7681 CT scans) and UC (7 studies; n = 858 CT scans), the pooled prevalence of penetrating IBD findings were low: abscesses/inflammatory masses [CD, 12% (95% CI, 10-14); UC, 3% (95% CI, 1-6)] and perforations [CD, 3% (95% CI, 2-4); UC, 1% (95% CI, 0-2)]. Rates of other IBD findings included: inflammation [CD, 43% (95% CI, 30-57); UC, 48% (95% CI, 31-65)] and obstructions [CD, 18% (95% CI, 13-23); UC, 9% (95% CI, 1-20)]. Non-IBD pathologies were uncommon: less than 5% each for pulmonary, non-IBD gastrointestinal, or genitourinary findings.

Conclusion

In this meta-analysis, we found low rates of serious penetrating IBD complications and non-IBD pathologies detected by abdominal CT in the ED. These findings suggest that more selective use of CT imaging in the ED may be warranted.

DOI

10.1093/ibd/izag053

PMID

41999574

Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.

Want more like this?

Browse more from the feed. A free account unlocks the full feed, saving and communities.

Back to the research feed

Create a free account · Sign in