PWE-064 Management Of Large Colonic Polyps In The Severn Deanery Hospitals: An Audit Of Current Practice

Abstract

ileo-caecal resection were excluded. Demographic data, TI pathology (endoscopic and histopathologic) and indications for colonoscopy were analysed. Results 8016 colonoscopies were performed with a caecal intubation rate of 90.3%. The endoscopists were of different grades including gastroenterologists, colorectal surgeons and a nurse endoscopist. 206 with ileo-caecal resection were excluded. Mean age was 61 with a female preponderance at 52.6%. The TI w as intubated in 1845 (23.5%). Endoscopic TI pathology was identified in 42 patients (2.3%). Histology was available for 31, of which 23 (1.3%) had confirmed histological abnormalities. Diagnoses on ileoscopy included one adenocarcinoma, one carcinoid tumour, one metastatic malignant melanoma and 20 with terminal ileitis, of which, 6 had histological Crohn's disease. The most common indications in those with TI pathology were diarrhoea (15), abdominal pain (8) and rectal bleeding (8). Conclusion Although the overall diagnostic yield was low, TI intubation identified significant pathologies requring further action, including three malignancies. Ileoscopy at colonoscopy is a simple manoeuvre, which, apart from quality assurance can identify important pathology. The most common indication in those with confirmed TI pathology was diarrhoea, therefore ileoscopy may have added diagnostic value in this context. Disclosure of Interest None Declared. PWE-063 COLONOSCOPY IN THE OVER NINETIES: HOW USEFUL AND SAFE IS IT?SK Butt*, A Chitembwe, K Besherdas. Gastroenterology, Chase Farm Hospital, London, UK 10. 1136/gutjnl-2014-307263.323 Introduction Colonoscopy is accepted as the gold standard imaging modality of the colon for investigation of colonic symptoms including altered bowel habit, anaemia, rectal bleeding and for the detection of colorectal cancer. The incidence of pathological findings within the colon in particular colorectal cancer increases with age, and the detection of these cancers comprise a major role of colonoscopy in the elderly population. However, colonoscopy in the elderly may be more difficult, as elderly patients are more likely than younger patients to have poor bowel preparations. Furthermore, complications of colonoscopy, in particular cardiovascular, maybe higher in this age group. To date no data exist in colonoscopies performed in those over 90 years of age. Methods The aim of the study was to assess the diagnostic yield and safety of colonoscopy in the very elderly patients over 90 years of age. A single centre, retrospective analysis of patients over 90 years of age in a district general hospital from north London was performed. The patients were identified using the Unisoft Endoscopy reporting software over a period between June 2006 to March 2013. Data obtained during the study period was scrutinised for indication, sedation administered, quality of bowel prep, findings of procedure, and complications. Results During the study period, 66 colonoscopies were performed out of a total 666 endoscopic procedures in patients over 90. The indicati...