Does a Colonoscopy After Acute Diverticulitis Affect its Management?

Schmilovitz‐Weiss, Hemda; Yalunin, Evgen; Boaz, Mona; Sehayek-Shabbat, Vered; Levin, Izhak; Chervinski, Alexandra; Atar, Eli; Niv, Yaron; Shirin, Haim

doi:10.1097/mcg.0b013e31823a43a1

Cited by 47 publications

(48 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In these studies malignant tumours were found in 0-2.8% of patients who underwent colonic imaging [13][14][15][16][17]. Two of these studies were performed in a similar design as ours; patients with clinical signs of diverticulitis were included, with or without radiological confirmation [13,15]. In two studies by Lau et al [16] and Westwood et al [14], patients were included from a CT scan database.…”

Section: Discussionmentioning

confidence: 99%

Routine Screening for Colon Cancer after Conservative Treatment of Diverticulitis

Schout¹,

Bilgen²,

Groenen

2012

Dig Surg

View full text Add to dashboard Cite

Background and Aims: It is generally advised to perform colonoscopy after conservatively treated diverticulitis because colon cancer may present itself with similar symptoms, laboratory and radiological results. With this study we investigated in what percentage of patients a malignancy was found by performing routine colonoscopy or radiologic imaging after a conservatively treated episode of diverticulitis, and whether this follow-up programme could be reserved for a selected group of patients. Methods: In our hospital, routine colonoscopy or, as a second choice, radiologic imaging has been standard practice over the last decade. We collected all colonoscopy and radiologic imaging results that were conducted of all 516 patients who were diagnosed with diverticulitis in this period. Results: Of those 516 patients, 378 had undergone colonoscopy, 45 radiologic imaging and 93 did not undergo any additional investigation. Eight cases of malignant neoplasia were found in those patients (2.1%), and an additional number of 40 adenomatous polyps (9.5%). Six out of 8 patients with colon cancer reported rectal blood loss, significant weight loss or persisting abdominal pain after being treated for diverticulitis. Conclusions: In patients who were conservatively treated with routine colonoscopy or radiologic imaging for apparent diverticulitis, a malignant tumour was found in the colon in 2.1% of them. If only performed in patients reporting alarm symptoms, a case of colon cancer would be missed in only 0.5% of patients conservatively treated for diverticulitis. Therefore, screening for colon cancer after conservative treatment of diverticulitis is only indicated in symptomatic patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Routine Screening for Colon Cancer after Conservative Treatment of Diverticulitis

Schout¹,

Bilgen²,

Groenen

2012

Dig Surg

View full text Add to dashboard Cite

show abstract

“…The vast majority of the studies draw the conclusion that colonoscopy after radiologically-confirmed uncomplicated diverticulitis is unnecessary to exclude malignancy [55][56][57][58][59][60], while it seems to be necessary after radiologically-confirmed complicated diverticulitis because the risk of malignancy in those patients is higher [61].…”

Section: Colonoscopy Following Acute Diverticulitismentioning

confidence: 99%

“…For example, Sallinen et al [55] recently claimed that routine colonoscopy after CT-proven uncomplicated diverticulitis seems to be unnecessary, but colonoscopy should be performed after an attack of complicated diverticulitis; Schmilovitz-Weiss et al [57] and Westwood at al. [58[ claimed that colonoscopy may not be required to confirm diagnosis of diverticulitis, since the overall incidence of advanced colonic neoplasia in these patients is not increased.…”

Section: Colonoscopy Following Acute Diverticulitismentioning

confidence: 99%

The Role of Colonoscopy in Managing Diverticular Disease of the Colon

Tursi

2015

JGLD

View full text Add to dashboard Cite

Diverticulosis of the colon is frequently found on routine colonoscopy, and the incidence of diverticular disease and its complications appears to be increasing. The role of colonoscopy in managing this disease is still controversial.Colonoscopy plays a key role in managing diverticular bleeding. Several techniques have been effectively used in this field, but band ligation seems to be the best in preventing rebleeding. Colonoscopy is also effective in posing a correct differential diagnosis with other forms of chronic colitis involving colon harbouring diverticula (in particular with Crohn's disease or Segmental Colitis Associated with Diverticulosis). The role of colonoscopy to confirm diagnosis of uncomplicated diverticulitis is still under debate, since the risk of advanced colonic neoplasia in patients admitted for acute uncomplicated diverticulitis is not increased as compared to the average-risk population. On the contrary, colonoscopy is mandatory if patients complain of persistent symptoms or after resolution of an episode of complicated diverticulitis. Finally, a recent endoscopic classification, called Diverticular Inflammation and Complications Assessment (DICA), has been developed and validated. This classification seems to be a promising tool for predicting the outcome of the colon harboring diverticula, but further, prospective studies have to confirm its predictive role on the outcome of the disease.

show abstract

“…In 100 patients, at least one polyp was detected in 32% of cases, an advanced adenoma was found in only one case, and in no patient was malignancy detected by colonoscopy 4-6 weeks after the end of the hospital treatment for acute diverticulitis [5]. Colonoscopy is therefore not associated with an elevated incidence of malignancy after diverticulitis [16]. A systematic literature search by Sai et al [17] in order to detect a colon carcinoma up to 24 weeks after CT diagnosis of diverticulitis identified ten studies with 771 documented patients.…”

Section: Question 5: Why Should a Colonoscopy Be Performed After An Ementioning

confidence: 99%

“…The present day use of endoscopes with diameters of 5 mm usually allows the examinations to be terminated or at least the stenotic region to be determined in almost all patients. If this is not possible, the examination should be discontinued and repeated electively in the interval [16]. …”

Section: Question 6: How Do You React When a (Screening) Endoscopy Rementioning

confidence: 99%

Colonoscopy in Acute Diverticulitis

Gross¹,

Labenz

Börsch³

et al. 2015

Visc Med

View full text Add to dashboard Cite

Does a Colonoscopy After Acute Diverticulitis Affect its Management?

Abstract: Our results suggest that colonoscopy does not affect the management of patients with acute diverticulitis nor alter the outcome. The current practice of a routine colonoscopy after acute diverticulitis, diagnosed by typical clinical symptoms and CT needs to be reevaluated.

Cited by 47 publications

References 20 publications

Routine Screening for Colon Cancer after Conservative Treatment of Diverticulitis

Routine Screening for Colon Cancer after Conservative Treatment of Diverticulitis

The Role of Colonoscopy in Managing Diverticular Disease of the Colon

Colonoscopy in Acute Diverticulitis

Contact Info

Product

Resources

About