Diverticula, Neoplasia, or Both?

Boulos, P B; Cowin, Alison P.; Karamanolis, D.G.; Clark, C. G.

doi:10.1097/00000658-198511000-00012

Cited by 32 publications

(3 citation statements)

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“…The polyps and ANL were found predominantly in the recto-sigmoid colon. This finding is consistent with other studies, where the left colon is the principal site of ANL and polyps [23][24][25].…”

Section: Discussionsupporting

confidence: 94%

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Diverticulosis and diverticulitis form no risk for polyps and colorectal neoplasia in 4,241 colonoscopies

Meurs-Szojda

Droste

Kuik

et al. 2008

Int J Colorectal Dis

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Background and aims There are conflicting data concerning the association between diverticular disease and colorectal carcinoma (CRC). This study was performed to determine the prevalence and association of diverticulosis, diverticulitis, polyps, and CRC. Materials and methods In a cross-sectional, retrospective study, we analyzed the colonoscopy reports of complete colonoscopies and patho-histological results of all patients referred for colonoscopy in a period of 3 months in 18 hospitals in The Netherlands. Diverticulosis was defined as three or more diverticula present and diverticulitis as diverticulosis with inflammation. Polyps were also coded according to localization and size. Advanced neoplastic lesions were defined as polyps ≥10 mm in diameter and/or villous architecture and/or adenomas with high grade dysplasia and/or invasive cancer. Actual and previous described CRC were registered. Results A total of 4,241 patients were included in the study [1,996 (47%) male], mean age of 59 and range 18-95. Diverticula, diverticulitis, and polyps were seen in 1,052 (25%), 75 (2%), and 1,282 (30%) patients, respectively. No association was found between patients with polyps and those with and without diverticulosis (p=0.478). Invasive adenocarcinoma and adenomas ≥10 mm were most frequently observed. CRC was present in 372 (9%) patients. Negative relation between diverticulosis and CRC and invasive adenocarcinoma was observed. No association was found between polyps and CRC and patients with diverticulitis and CRC. In conclusion, there is no relation between patients with diverticulosis and higher incidence of polyps or CRC when using age-stratified analysis. No increased risk for polyps or CRC was found in patients with diverticulitis.

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Section: Discussionsupporting

confidence: 94%

“…Krones et al [19] looked retrospective at resected specimen for CRC for diverticulitis and in resected diverticulitis for ANP. In the CRC group, the incidence of diverticulosis was only 18% and ANP in the diverticulitis group only 6%, both very low numbers [23][24][25]. Subsequently, a negative relationship was found.…”

Section: Discussionmentioning

confidence: 89%

Diverticulosis and diverticulitis form no risk for polyps and colorectal neoplasia in 4,241 colonoscopies

Meurs-Szojda

Droste

Kuik

et al. 2008

Int J Colorectal Dis

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“…This viewpoint is also suppotted by other investigators. 2 Although Dr Ertan notes that Regarding surgical resection, Dr…”

Section: Treatment Of Colonic Diverticulitismentioning

confidence: 99%

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Nadler¹,

Ertan

Holmes

et al. 1991

Postgraduate Medicine

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Meta-analysis of the role of colonoscopy after an episode of left-sided acute diverticulitis

Rottier

Dijk

Geloven

et al. 2019

British Journal of Surgery

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Background Routine colonoscopy was traditionally recommended after acute diverticulitis to exclude coexistent malignancy. Improved CT imaging may make routine colonoscopy less required over time but most guidelines still recommend it. The aim of this review was to assess the role of colonoscopy in patients with CT‐proven acute diverticulitis. Methods PubMed and Embase were searched for studies reporting the prevalence of advanced colorectal neoplasia (ACN) or colorectal carcinoma in patients who underwent colonoscopy within 1 year after CT‐proven left‐sided acute diverticulitis. The prevalence was pooled using a random‐effects model and, if possible, compared with that among asymptomatic controls. Results Seventeen studies with 3296 patients were included. The pooled prevalence of ACN was 6·9 (95 per cent c.i. 5·0 to 9·4) per cent and that of colorectal carcinoma was 2·1 (1·5 to 3·1) per cent. Only two studies reported a comparison with asymptomatic controls, showing comparable risks (risk ratio 1·80, 95 per cent c.i. 0·66 to 4·96). In subgroup analysis of patients with uncomplicated acute diverticulitis, the prevalence of colorectal carcinoma was only 0·5 (0·2 to 1·2) per cent. Conclusion Routine colonoscopy may be omitted in patients with uncomplicated diverticulitis if CT imaging is otherwise clear. Patients with complicated disease or ongoing symptoms should undergo colonoscopy.

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Diverticula, Neoplasia, or Both?

Cited by 32 publications

References 5 publications

Diverticulosis and diverticulitis form no risk for polyps and colorectal neoplasia in 4,241 colonoscopies

Diverticulosis and diverticulitis form no risk for polyps and colorectal neoplasia in 4,241 colonoscopies

Readers' Forum

Meta-analysis of the role of colonoscopy after an episode of left-sided acute diverticulitis

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