EP 687 Are we Overscoping?: An Audit of Colonoscopic Follow-up in Acute Diverticulitis Management
Sharmilaa Lagunathan, Ajay Aspari, Tarek Mehaina, Keerthana SoundararajanAbstract
Aims
To evaluate the documentation of Hinchey classification and the appropriateness of follow-up colonoscopy requests in line with ASGBI and ACPGBI guidelines, which recommend endoscopic evaluation for complicated diverticulitis (Hinchey 2 and above) at 6–8 weeks to exclude malignancy.
Methods
A retrospective audit of 115 consecutive admissions for acute diverticulitis was performed. We assessed the documentation of disease severity using the Modified Hinchey Classification and analysed the clinical indication for post-discharge colonoscopy requests.
Results
Documentation of disease severity was poor; only 8.7% (10/115) of admissions had a formal Hinchey score recorded. Of the 115 patients, 27 with uncomplicated diverticulitis (Hinchey 1/2a) underwent follow-up colonoscopy that was deemed unnecessary by national standards. Critically, zero "sinister" findings or malignancies were identified in this over-investigated group.
Conclusion
This audit demonstrates a clear failure in both documentation and follow-up stratification. We are significantly "over-scoping" uncomplicated cases, introducing procedural risk without clinical benefit or diagnostic yield. Standardising the documentation of Hinchey classification is essential to prevent unnecessary invasive investigations and to ensure that high-risk, complicated cases are not missed.