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Findings on Colonoscopy after Diverticulitis: A Multicenter Review
Adam Studniarek1, Kunal Kochar2, Christina Warner1
1From the *Division of Colon and Rectal Surgery, University of Illinois at Chicago, Chicago, Illinois.
The American Surgeon
|January 8, 2020
Summary
Patients with diverticulitis have a higher risk of advanced adenomas and adenocarcinomas. A colonoscopy after acute diverticulitis is recommended to detect these significant findings.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Oncology
Background:
- Diverticular disease affects a significant portion of the population.
- Acute diverticulitis occurs in 1-4% of patients with diverticulosis.
- Current guidelines suggest colonoscopy post-diverticulitis resolution.
Purpose of the Study:
- To assess the diagnostic yield of colonoscopy after acute diverticulitis.
- To determine the prevalence of significant findings, including advanced adenomas and adenocarcinomas, in this patient group.
Main Methods:
- Retrospective analysis of 584 patients undergoing colonoscopy after acute diverticulitis.
- Data collected from November 2005 to August 2017 across three major teaching hospitals.
- Definition of advanced adenomas included size (≥1 cm), serrated, tubulovillous, or villous histology.
Main Results:
- Colonoscopy was completed in 84% of patients (488/584).
- Significant findings included advanced adenomas (5.4%) and adenocarcinomas (1.5%).
- Prevalence of advanced adenomas and adenocarcinomas was notably higher than in average-risk individuals.
Conclusions:
- Colonoscopy after acute diverticulitis reveals a relatively high incidence of advanced adenomas and adenocarcinomas.
- Findings support the continued recommendation for colonoscopy in patients following an episode of diverticulitis.
- This screening aids in early detection and management of colorectal neoplasia.
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