Colonoscopy after the first episode of acute diverticulitis: challenging management paradigms

N. Horesh*, Y. Saeed, H. Horesh, Y. Berger, C. Speter, R. Pery, D. Rosin, M. Gutman, O. Zmora

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Colonoscopy is commonly recommended after the first episode of acute diverticulitis to exclude colorectal neoplasia. Recent data have challenged this paradigm due to insufficient diagnostic yield. The aim of this study was to assess whether colonoscopy after the first episode of acute diverticulitis is needed to exclude colorectal neoplasia. Methods: We performed a retrospective cohort analysis of medical records of patients admitted for the first episode of acute diverticulitis between January 2008 and December 2012. Ambulatory colonoscopy was routinely recommended at discharge. Clinical follow-up and telephone surveys were used for data collection. Results: Four hundred and twenty-five patients with a mean age of 62.6 years (range 21–98 years) were admitted during the 5-year period. Three hundred and ten (72.9 %) patients underwent colonoscopy at median time of 3.2 months after discharge. Five patients (1.6 %) of the 310 available for evaluation had malignant findings in colonoscopy. Of those, one patient had rectal carcinoma away from the inflamed site and one had colonic lymphoma. None of the 95 patients <50 years of age was found to have adenocarcinoma of the colon. Conclusions: Cancer is rarely detected in colonoscopy following the first episode of acute diverticulitis. These results question this indication for colonoscopy, especially in patients under 50.

Original languageEnglish
Pages (from-to)383-387
Number of pages5
JournalTechniques in Coloproctology
Volume20
Issue number6
DOIs
StatePublished - 1 Jun 2016

Keywords

  • Acute diverticulitis
  • Colon cancer
  • Colonoscopy
  • Colorectal surgery

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