SP4.2.9 Investigation of patients with qFIT >400µg/g during the initial stages of the COVID-19 pandemic

Background During the initial stages of the COVID-19 pandemic non-emergency endoscopy was suspended as per BSG recommendations, resulting in altered pathways for investigation of suspected malignancies. In our unit, patients referred via suspected colorectal cancer (CRC) pathways with a quantitative faecal immunochemical test (qFIT) >400 µg/g were offered CT imaging in the first instance. Methods We accessed our electronic records to retrospectively identify patients referred with a qFIT >400 µg/g between March and May 2020. Patient demographics, previous medical history, and referral details were recorded. Primary outcome was incidence of new CRC diagnosis. Results 21 patients were included. Median follow-up was 218 days, and median time from referral to CT was 17 days. 3 (14.3%) patients had new cancer diagnoses;2 CRC and 1 lung. 42.8% of patients had normal investigations, or benign colorectal pathology. 95.2% patients went on to have an endoscopy; low risk polyps (28.6%), high risk polyps (4.8%) and IBD (9.6%) were identified. 57.1% of patients were discharged following endoscopy, with the remaining 42.9% needing further management which included referral to other specialties and repeat scopes. Discussion and conclusion CT scanning did not reduce the need for subsequent endoscopy, but aided in prioritising patients for subsequent investigation. There were no cases of CRC identified endoscopically which were not identified by CT imaging. In conclusion, CT is a viable alternative to endoscopy when restrictions are placed on endoscopy services.

ACCIDENTAL INGESTION OF CYLINDRICAL BATTERIES IN CHILDREN – INTERVENTIONAL OR CONSERVATIVE MANAGEMENT?

Ingestion of cylindrical batteries is a rare condition in children. There are no clear guidelines regarding the appropriate management of this condition. We present 2 such cases; one patient required endoscopic removal of the battery, while in the other one the battery passed spontaneously. We recommend that such cases be admitted for monitoring and treated on an individual basis, according to the clinical picture, X-ray data and the availability of pediatric emergency endoscopy.

Safety precautions for otorhinolaryngologists during the COVID-19 pandemic

<p>As COVID rapidly spreads through respiratory droplets, health care workers who perform aerosol generating diagnostic and therapeutic procedures, such as otolaryngologists–head and neck surgeons, are particularly at risk. In the article guidelines regarding attending a patient in ENT OPD and emergency, endoscopy examination, taking biopsy, operation theatre (OT) setting and precautions and guidelines to be followed while doing ENT and head and neck operations have been discussed based on review of literature.</p>