WTP7.9 Optimising Appropriate Referral, Early Diagnosis and Management of Patients Presenting to the Emergency Department with Right Iliac Fossa Pain; a Collaborative Approach in The Design of Local Right Iliac Fossa Pain Pathway

Abstract Diagnostic uncertainty in patients presenting with right iliac fossa (RIF) pain to the Emergency Department (ED) is well established and multifactorial, leading challenges selecting most appropriate specialty for initial referral. This study investigates local practice, which will form basis RIF pathway development. Methods We collected prospective data over one month presentations our ED, onward referral General Surgery (December 2022 – January 2023). included demographics, symptoms, appendicitis likelihood utilising validated scoring tools, investigations, management final histology. The number of women undergoing gynaecological review was also assessed, as were negative laparoscopy rates. Results Data collection revealed 46 presented pain: 30(65%) female, median age 29(18-44), 16(35%) male 35(21-53.) Thirteen (28%) underwent diagnostic laparoscopy, two negative, female. Ultrasound scan (USS) conducted 70% females, 6% males; CT 31% males, 27% females. Gynaecology & USS 38% women. Overall, 87% had imaging. Two a without Acute diagnosed definitively 21%. Conclusions majority this premenopausal cohort poses challenge. Further required, underway, help understand best way manage these patients. outcomes highlight need improve referral, timely imaging, certainty avoidance laparoscopy.