{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T18:18:53Z","timestamp":1788286733991,"version":"build-2803163510"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:00:00Z","timestamp":1776470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 19 studies were analyzed. Among patients with CD (15 studies; n\u2009=\u20097681 CT scans) and UC (7 studies; n\u2009=\u2009858 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izag053","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T12:16:18Z","timestamp":1773404178000},"page":"1722-1730","source":"Crossref","is-referenced-by-count":0,"title":["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"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5392-7627","authenticated-orcid":false,"given":"Althaf","family":"Azward","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Ottawa , Ottawa, Ontario, K1H 8L6,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Ripstein","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ottawa , Ottawa, Ontario, K1H 8L6,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgard","family":"Medawar","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ottawa , Ottawa, Ontario, K1H 8L6,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Murthy","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ottawa , Ottawa, Ontario, K1H 8L6,","place":["Canada"]},{"name":"Ottawa Hospital Research Institute, The Ottawa Hospital , Ottawa, Ontario, K1H 8L6,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blair","family":"Macdonald","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute, The Ottawa Hospital , Ottawa, Ontario, K1H 8L6,","place":["Canada"]},{"name":"Department of Diagnostic Imaging, University of Ottawa , Ottawa, Ontario, K1H 8L6,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Ottawa , Ottawa, Ontario, K1H 8L6,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia H","family":"Seow","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology & Hepatology, Cumming School of Medicine, University of Calgary , Calgary, Alberta, T2N 2T8,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddharth","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, University of California San Diego , San Diego, California, 92093,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey D","family":"McCurdy","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ottawa , Ottawa, Ontario, K1H 8L6,","place":["Canada"]},{"name":"Ottawa Hospital Research Institute, The Ottawa Hospital , Ottawa, Ontario, K1H 8L6,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,4,18]]},"reference":[{"key":"2026090114012045000_izag053-B1","doi-asserted-by":"publisher","first-page":"1380","DOI":"10.1016\/j.mayocp.2015.07.011","article-title":"Answers to common questions about the use and safety of CT scans","volume":"90","author":"McCollough","year":"2015","journal-title":"Mayo Clin Proc"},{"key":"2026090114012045000_izag053-B2","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1093\/jcag\/gwac029","article-title":"Persistently high rates of abdominal computed tomography imaging among patients with inflammatory bowel disease who present to the Emergency Department","volume":"6","author":"Kandel","year":"2023","journal-title":"J Can Assoc Gastroenterol"},{"key":"2026090114012045000_izag053-B3","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjaf001","article-title":"Radiation exposure in patients with inflammatory bowel disease","volume":"19","author":"Jorissen","year":"2025","journal-title":"J Crohn Colitis"},{"key":"2026090114012045000_izag053-B4","doi-asserted-by":"publisher","first-page":"2015","DOI":"10.1111\/j.1572-0241.2008.01920.x","article-title":"Diagnostic ionizing radiation exposure in a population-based cohort of patients with inflammatory bowel disease","volume":"103","author":"Peloquin","year":"2008","journal-title":"Am J Gastroenterol"},{"key":"2026090114012045000_izag053-B5","doi-asserted-by":"publisher","first-page":"1524","DOI":"10.1136\/gut.2008.151415","article-title":"Crohn\u2019s disease: factors associated with exposure to high levels of diagnostic radiation","volume":"57","author":"Desmond","year":"2008","journal-title":"Gut"},{"key":"2026090114012045000_izag053-B6","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1186\/s12876-024-03264-1","article-title":"Medical radiation exposure in inflammatory bowel disease: an updated meta-analysis","volume":"24","author":"Lu","year":"2024","journal-title":"BMC Gastroenterol"},{"key":"2026090114012045000_izag053-B7","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1093\/jcag\/gwae001","article-title":"Perceived value of computed tomography imaging for patients with inflammatory bowel disease in the emergency department: a Canadian survey","volume":"7","author":"Roda","year":"2024","journal-title":"J Can Assoc Gastroenterol"},{"key":"2026090114012045000_izag053-B8","doi-asserted-by":"crossref","DOI":"10.1002\/9781119536604","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins","year":"2019","edition":"2nd"},{"key":"2026090114012045000_izag053-B9","author":"Azward"},{"key":"2026090114012045000_izag053-B10","author":"Study Quality Assessment Tools","year":"2021"},{"key":"2026090114012045000_izag053-B11","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","article-title":"Meta-analysis in clinical trials","volume":"7","author":"DerSimonian","year":"1986","journal-title":"Control Clin Trials"},{"key":"2026090114012045000_izag053-B12","doi-asserted-by":"publisher","first-page":"1294","DOI":"10.1016\/j.jclinepi.2011.03.017","article-title":"GRADE guidelines: 7. Rating the quality of evidence\u2014inconsistency","volume":"64","author":"Guyatt","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"2026090114012045000_izag053-B13","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1186\/s12873-021-00512-5","article-title":"Abdominopelvic CT-scan in emergency departments for patients with suspected complications of Crohn\u2019s disease: a single tertiary center experience","volume":"21","author":"Verdalle-Cazes","year":"2021","journal-title":"BMC Emerg Med"},{"key":"2026090114012045000_izag053-B14","doi-asserted-by":"publisher","first-page":"S495","DOI":"10.14309\/00000434-201410002-01671","article-title":"Use of computed tomography on inflammatory bowel patients in a community hospital setting: what are the rates of urgent findings?","volume":"109","author":"Elbaum","year":"2014","journal-title":"Am J Gastroenterol"},{"key":"2026090114012045000_izag053-B15","doi-asserted-by":"publisher","first-page":"1702","DOI":"10.1016\/j.cgh.2014.02.036","article-title":"Risk stratification of emergency department patients with Crohn\u2019s disease could reduce computed tomography use by nearly half","volume":"12","author":"Govani","year":"2014","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2026090114012045000_izag053-B16","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1177\/2050640616658218","article-title":"Validation of a tool predicting important findings on computed tomography among Crohn\u2019s disease patients","volume":"5","author":"Govani","year":"2017","journal-title":"United European Gastroenterol J"},{"key":"2026090114012045000_izag053-B17","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1111\/apt.12410","article-title":"The impact of abdominal computed tomography in a tertiary referral centre emergency department on the management of patients with inflammatory bowel disease","volume":"38","author":"Israeli","year":"2013","journal-title":"Aliment Pharmacol Ther"},{"key":"2026090114012045000_izag053-B18","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1007\/s10620-014-3298-9","article-title":"Predictors of urgent findings on abdominopelvic CT in patients with Crohn\u2019s disease presenting to the Emergency Department","volume":"60","author":"Jung","year":"2015","journal-title":"Dig Dis Sci"},{"key":"2026090114012045000_izag053-B19","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.cgh.2011.09.005","article-title":"Use of abdominopelvic computed tomography in emergency departments and rates of urgent diagnoses in Crohn\u2019s disease","volume":"10","author":"Kerner","year":"2012","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2026090114012045000_izag053-B20","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1097\/MCG.0000000000000508","article-title":"Utility of emergency department use of abdominal pelvic computed tomography in the management of Crohn\u2019s disease","volume":"50","author":"Koliani-Pace","year":"2016","journal-title":"J Clin Gastroenterol."},{"key":"2026090114012045000_izag053-B21","doi-asserted-by":"publisher","first-page":"1559","DOI":"10.1016\/j.dld.2021.06.020","article-title":"Machine learning for selecting patients with Crohn\u2019s disease for Abdominopelvic computed tomography in the emergency department","volume":"53","author":"Konikoff","year":"2021","journal-title":"Dig Liver Dis"},{"key":"2026090114012045000_izag053-B22","doi-asserted-by":"publisher","first-page":"S770","DOI":"10.14309\/00000434-201510001-01811","article-title":"A predictive model for identifying clinically actionable findings on CT scan in Crohn\u2019s disease patients presenting to the Emergency Department","volume":"110","author":"Loudin","year":"2015","journal-title":"Am J Gastroenterol"},{"key":"2026090114012045000_izag053-B23","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1097\/mcg.0000000000001634","article-title":"Less emergency department abdominopelvic computed tomography for patients with Crohn\u2019s disease","volume":"56","author":"Riskin Geuz","year":"2022","journal-title":"J Clin Gastroenterol"},{"key":"2026090114012045000_izag053-B24","doi-asserted-by":"publisher","first-page":"S448","DOI":"10.14309\/01.ajg.0000777300.04741.1e","article-title":"S942 CT scans in Crohn\u2019s disease patients presenting to the Emergency Department","volume":"116","author":"Saeed","year":"2021","journal-title":"Am J Gastroenterol"},{"key":"2026090114012045000_izag053-B25","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1093\/jcag\/gwy008.130","article-title":"A129 rates and clinical predictors of urgent findings on abdominopelvic computed tomography in emergency department patients with inflammatory bowel disease","volume":"1","author":"Wishart","year":"2018","journal-title":"J Can Assoc Gastroenterol"},{"key":"2026090114012045000_izag053-B26","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1016\/j.crohns.2013.11.003","article-title":"Predictive factors for clinically actionable computed tomography findings in inflammatory bowel disease patients seen in the emergency department with acute gastrointestinal symptoms","volume":"8","author":"Yarur","year":"2014","journal-title":"J Crohns Colitis"},{"key":"2026090114012045000_izag053-B27","doi-asserted-by":"publisher","first-page":"2663","DOI":"10.1007\/s00261-020-02514-6","article-title":"A clinical and radiographic model to predict surgery for acute small bowel obstruction in Crohn\u2019s disease","volume":"45","author":"Lowe","year":"2020","journal-title":"Abdom Radiol (NY)"},{"key":"2026090114012045000_izag053-B28","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/j.acra.2009.10.023","article-title":"Comparison of conventional abdominal CT with MR-enterography in patients with active Crohn\u2019s disease and acute abdominal pain","volume":"17","author":"Schreyer","year":"2010","journal-title":"Acad Radiol"},{"key":"2026090114012045000_izag053-B29","doi-asserted-by":"publisher","first-page":"S794","DOI":"10.1016\/s0016-5085(16)32693-2","article-title":"Utility of emergency department CT scans in patients with ulcerative colitis","volume":"150","author":"Booras","year":"2016","journal-title":"Gastroenterology"},{"key":"2026090114012045000_izag053-B30","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1097\/MIB.0000000000000321","article-title":"Utility of CT in the emergency department in patients with ulcerative colitis","volume":"21","author":"Gashin","year":"2015","journal-title":"Inflamm Bowel Dis"},{"key":"2026090114012045000_izag053-B31","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1186\/s12874-021-01381-z","article-title":"Conducting proportional meta-analysis in different types of systematic reviews: a guide for synthesisers of evidence","volume":"21","author":"Barker","year":"2021","journal-title":"BMC Med Res Methodol"},{"key":"2026090114012045000_izag053-B32","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1111\/ijcp.12187","article-title":"Temporal trends in imaging and associated radiation exposure in inflammatory bowel disease","volume":"67","author":"Holmes","year":"2013","journal-title":"Int J Clin Pract"},{"key":"2026090114012045000_izag053-B33","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.1093\/ecco-jcc\/jjz043","article-title":"A validated score assessing the risk of an intra-abdominal abscess in patients with Crohn\u2019s disease presenting at the emergency department","volume":"13","author":"Khoury","year":"2019","journal-title":"J Crohns Colitis"},{"key":"2026090114012045000_izag053-B34","doi-asserted-by":"publisher","first-page":"100459","DOI":"10.1016\/j.lanwpc.2022.100459","article-title":"The carbon footprint of hospital diagnostic imaging in Australia","volume":"24","author":"McAlister","year":"2022","journal-title":"Lancet Reg Health West Pac"},{"key":"2026090114012045000_izag053-B35","doi-asserted-by":"publisher","first-page":"2501","DOI":"10.1097\/mib.0b013e31828dc6b6","article-title":"Diagnostic medical radiation in inflammatory bowel disease","volume":"19","author":"Swanson","year":"2013","journal-title":"Inflamm Bowel Dis"},{"key":"2026090114012045000_izag053-B36","doi-asserted-by":"publisher","first-page":"2623","DOI":"10.14309\/ajg.0000000000003339","article-title":"Fecal calprotectin correlates with disease extent but remains a reliable marker of mucosal healing in ulcerative colitis","volume":"120","author":"Steinsb\u00f8","year":"2025","journal-title":"Am J Gastroenterol"},{"key":"2026090114012045000_izag053-B37","doi-asserted-by":"publisher","first-page":"299","DOI":"10.15403\/jgld.2014.1121.273","article-title":"Fecal calprotectin in assessing inflammatory bowel disease endoscopic activity: a diagnostic accuracy meta-analysis","volume":"27","author":"Rokkas","year":"2018","journal-title":"J Gastrointestin Liver Dis"},{"key":"2026090114012045000_izag053-B38","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1159\/000520212","article-title":"Intestinal ultrasound in inflammatory bowel disease: a valuable and increasingly important tool","volume":"29","author":"Frias-Gomes","year":"2022","journal-title":"GE Port J Gastroenterol"},{"key":"2026090114012045000_izag053-B39","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1093\/ecco-jcc\/jjab175","article-title":"Point-of-care intestinal ultrasound in IBD patients: Disease Management and diagnostic yield in a real-world cohort and proposal of a point-of-care algorithm","volume":"16","author":"Bots","year":"2022","journal-title":"J Crohns Colitis"},{"key":"2026090114012045000_izag053-B40","doi-asserted-by":"publisher","first-page":"3429","DOI":"10.1093\/ibd\/izaf196","article-title":"Integrating intestinal ultrasound to clinical trials in patients with Crohn\u2019s disease: opportunities and challenges","volume":"31","author":"Jairath","year":"2025","journal-title":"Inflamm Bowel Dis"},{"key":"2026090114012045000_izag053-B41","author":"Gastroenterology recommendations","year":"2025"},{"key":"2026090114012045000_izag053-B42","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1097\/MIB.0000000000001152","article-title":"Modified Delphi process for the development of choosing wisely for inflammatory bowel disease","volume":"23","author":"Nguyen","year":"2017","journal-title":"Inflamm Bowel Dis"},{"key":"2026090114012045000_izag053-B43","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1093\/ecco-jcc\/jjy113","article-title":"Ecco-ESGAR guideline for Diagnostic Assessment in IBD part 1: Initial diagnosis, monitoring of known IBD, detection of complications","volume":"13","author":"Maaser","year":"2018","journal-title":"J Crohn Colitis"},{"key":"2026090114012045000_izag053-B44","doi-asserted-by":"publisher","first-page":"s1","DOI":"10.1136\/gutjnl-2019-318484","article-title":"British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults","volume":"68","author":"Lamb","year":"2019","journal-title":"Gut"},{"key":"2026090114012045000_izag053-B45","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1038\/ajg.2018.27","article-title":"ACG Clinical Guideline: management of Crohn\u2019s disease in adults","volume":"113","author":"Lichtenstein","year":"2018","journal-title":"Am J Gastroenterol"},{"key":"2026090114012045000_izag053-B46","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1007\/s12664-017-0804-y","article-title":"Imaging of the small intestine in Crohn\u2019s disease: joint position statement of the Indian society of gastroenterology and Indian radiological and imaging association","volume":"36","author":"Kedia","year":"2017","journal-title":"Indian J Gastroenterol"},{"key":"2026090114012045000_izag053-B47","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1016\/j.dld.2019.10.015","article-title":"The management of emergency hospital visits for inflammatory bowel diseases: a French national expert consensus report","volume":"52","author":"H\u00e9buterne","year":"2020","journal-title":"Dig Liver Dis"}],"container-title":["Inflammatory Bowel Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article-pdf\/32\/9\/1722\/68110387\/izag053.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article-pdf\/32\/9\/1722\/68110387\/izag053.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T18:01:46Z","timestamp":1788285706000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article\/32\/9\/1722\/8658707"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,18]]},"references-count":47,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,4,18]]},"published-print":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ibd\/izag053","relation":{},"ISSN":["1078-0998","1536-4844"],"issn-type":[{"value":"1078-0998","type":"print"},{"value":"1536-4844","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,4,18]]}}}