The Necessity of a Colonoscopy after an Acute Diverticulitis Event in Adults Less Than 50 Years Old

Abstract

IntroductionAcute diverticulitis is defined as a macroscopic inflammation of a diverticulum or diverticula. Approximately, 4.0% of patients with diverticulosis present with an acute diverticulitis event: with the incidence increasing in the younger patient population. According to the American Gastrointestinal Association, a colonoscopy should be performed six to eight weeks after resolution of acute diverticulitis. The purpose of this study is to determine if there is malignancy after an acute diverticulitis event in adults less than 50 years old.Methods A retrospective chart review study was performed at Loyola MacNeal Hospital in Berwyn, Illinois. Patients between the ages of 18 and49 years with acute diverticulitis were identified. Of the identified patients, those who underwent colonoscopy after a computed tomography (CT)-verified acute diverticulitis event were recorded. Colonoscopy findings, as well as pathology results, were recorded.Results A total of 295 patient presented with diverticulitis. Of these 295 patients, 111 patients underwent colonoscopy post diverticulitis event. Of the 111 patients, 86 were after uncomplicated event and 25 were after a complicated diverticulitis event. Pre-malignant tubular adenomas were found in 12.8% (11/86) of patients with acute uncomplicated diverticulitis and 24.0% (6/25) of the patients with complicated diverticulitis. No cases of neoplasm were found.Conclusion Of the 111 patients who underwent colonoscopy after an acute diverticulitis event, no malignancy was found in patients less than 50 years of age.

Endoscopic findings after CT proven acute diverticulitis: a systematic review and meta‐analysis

“…A total of 68 studies with 13 905 patients were included 6,24–90 . There were four prospective studies and one retrospective review of a prospective study 44,60,61,77,89 .…”

“…There were 13 296 patients from 65 studies who underwent a follow up colonoscopy 6,24–42,44–65,67–79,81–90 . The remaining three studies (231 patients) reported follow up with either a colonoscopy or flexible sigmoidoscopy and did not differentiate between the two 43,66,80 .…”

“…25,30,35,49,50,59,60,62,63,78,85,89 There were 13 296 patients from 65 studies who underwent a follow up colonoscopy. 6,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][67][68][69][70][71][72][73][74][75][76][77][78][79][81][82][83][84][85][86][87][88]…”

“…24,32,38,43,44,50,51,53,56,62,64,[69][70][71][72]77,78,80,81,85,88 Non advanced adenomas detection rate was 17.1% (1247/7283) from 46 studies. 6,24,[26][27][28][29][30][31]36,37,[39][40][41][42]44,[47][48][49][50]52,53,55,[57][58][59][60][61][62][63][64][65][67]…”

“…6,24,[26][27][28][29][30][31]36,37,[39][40][41][42]44,[47][48][49][50]52,53,55,[57][58][59][60][61][62][63][64][65][67][68][69][70][71]73,74,77,[79][80][81][82]85,87,88 Hyperplastic polyps were detected in 9.7% (475/4868) of patients from 26 studies. [27][28][29][30][31]42,44,...…”