Direct visualisation of the bowel lumen is recommended as follow up for all acute diverticulitis cases. This includes CT Colonography (CTC). In Newcastle Upon Tyne Hospitals (NUTH), surgical practice is that all patients admitted with diverticulitis have a follow up CTC approximately 3 months from discharge.

A Radiology Information system (RIS) search of CTCs performed in NUTH trust between 1/1/2019-31/12/2019. Reports were excluded if the indication was not acute diverticulitis follow-up. Remaining reports were assessed for compliance with standards.Joint guidance from the BSGAR and RCR: Standards of practice for CTC (2021); and Royal College of Surgeons commissioning guide into Colonic Diverticular disease (2014).Percentage of CTC reports following acute diverticulitis accordant with standards of practice.1. CTC should be completed within 3 months of acute episode 2. Local target of 100% sensitivity for colonic malignancy. 3. Polyp identification rate of >13% of patients 4. Indeterminate CTC report (leading to further investigation) in <25%References: Royal College of Radiologists. (2021). Joint guidance from the BSGAR and RCR: Standards of practice for CTC.Royal College of Surgeons. (2014). Colonic Diverticular disease - Commissioning Guide.

Of the 1282 CTC reports identified, 1207 (94%) were excluded. Of the remaining 75 reports, no cases had a colonic malignancy later identified which was not reported at the time of CTC (100% sensitivity). There was a wide range in the time interval to CTC, from 3 to 69 weeks. 15 cases (20%) had polyps identified. 6 reports (8%) were indeterminate (C score of 3c) and required further investigation.

CTC in acute diverticulitifollow-up achieved targetin malignancy and polyp sensitivity, and indeterminate rates. However, the time interval wavery variable and could be standardised to produce a more robust pathway for patientrequiring acute diverticulitifollow-up. Resulthave been presentregionally.

CTC in acute diverticulitis follow up has superseded the Colonoscopy at NUTH. This has been a success story for the Radiology teams with increased trust in CTC reports from the General Surgical teams. This audit shows this trust is well placed with national standards met using this less invasive, more accessible and better tolerated test. Going forward this pathway could be standardised to set up a routine follow up time interval for CTC following acute diverticulitis which would stream line patient management and improve efficiency.