Do We Need Colonoscopy Following Acute Diverticulitis Detected on Computed Tomography to Exclude Colorectal Malignancy?

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Abstract

Background: Although colonoscopy verification is warranted after an acute event of diverticulitis to exclude underlying malignancy, little evidence is available to support the recommendations. Aim: The aim of this study was to examine whether subsequent colonoscopy is warranted in patients with diverticulitis on computed tomography (CT). Methods: The study was composed of patients diagnosed with acute diverticulitis on CT scan from January 2001 to March 2013. Patients who had subsequent colonoscopy within a year from the date of CT were included. For each diverticulitis case, two age- (±5 years) and sex-matched controls were identified from healthy individuals who had received screening colonoscopy. We evaluated the diagnostic yield of advanced colonic neoplasia in colonoscopy. Results: One hundred and forty-nine patients underwent subsequent colonoscopy within a year from the date of CT. Among the patients, 11 (7.4 %) had colon cancer and 5 (3.4 %) had advanced adenoma. A case–control study revealed that the odds of detecting an advanced neoplasia among patients with diverticulitis on CT were approximately 8.8 times greater than in the age- and sex-matched controls [OR 8.84; 95 % CI 2.90–26.96; p < 0.001]. On analysis of the diverticulitis group, age (≥50 years) is an independent risk factor for detecting advanced colonic neoplasia. Conclusions: The yield of advanced colonic neoplasia was substantially higher in patients with acute diverticulitis than in asymptomatic, average-risk individuals. Colonoscopy verification is warranted in patients with diverticulitis detected on CT, especially in those aged 50 years or older.

Original languageEnglish
Pages (from-to)2236-2242
Number of pages7
JournalDigestive Diseases and Sciences
Volume59
Issue number9
DOIs
StatePublished - 1 Sep 2014

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Diverticulitis
Colonoscopy
Tomography
Neoplasms
Adenoma
Colonic Neoplasms
Age Groups

Keywords

  • Adenoma
  • Colon cancer
  • Colonoscopy
  • Diverticulitis

Cite this

@article{9c1cd3b7eb4d443aa9a4d3bc36d5355f,
title = "Do We Need Colonoscopy Following Acute Diverticulitis Detected on Computed Tomography to Exclude Colorectal Malignancy?",
abstract = "Background: Although colonoscopy verification is warranted after an acute event of diverticulitis to exclude underlying malignancy, little evidence is available to support the recommendations. Aim: The aim of this study was to examine whether subsequent colonoscopy is warranted in patients with diverticulitis on computed tomography (CT). Methods: The study was composed of patients diagnosed with acute diverticulitis on CT scan from January 2001 to March 2013. Patients who had subsequent colonoscopy within a year from the date of CT were included. For each diverticulitis case, two age- (±5 years) and sex-matched controls were identified from healthy individuals who had received screening colonoscopy. We evaluated the diagnostic yield of advanced colonic neoplasia in colonoscopy. Results: One hundred and forty-nine patients underwent subsequent colonoscopy within a year from the date of CT. Among the patients, 11 (7.4 {\%}) had colon cancer and 5 (3.4 {\%}) had advanced adenoma. A case–control study revealed that the odds of detecting an advanced neoplasia among patients with diverticulitis on CT were approximately 8.8 times greater than in the age- and sex-matched controls [OR 8.84; 95 {\%} CI 2.90–26.96; p < 0.001]. On analysis of the diverticulitis group, age (≥50 years) is an independent risk factor for detecting advanced colonic neoplasia. Conclusions: The yield of advanced colonic neoplasia was substantially higher in patients with acute diverticulitis than in asymptomatic, average-risk individuals. Colonoscopy verification is warranted in patients with diverticulitis detected on CT, especially in those aged 50 years or older.",
keywords = "Adenoma, Colon cancer, Colonoscopy, Diverticulitis",
author = "Choi, {Young Hoon} and Seongjoon Ko and Kim, {Ji Won} and Kim, {Byeong Gwan} and Lee, {Kook Lae} and Im, {Jong Pil} and Joosung Kim and Jung, {Hyun Chae}",
year = "2014",
month = "9",
day = "1",
doi = "10.1007/s10620-014-3151-1",
language = "English",
volume = "59",
pages = "2236--2242",
journal = "Digestive diseases and sciences",
issn = "0163-2116",
publisher = "Springer New York",
number = "9",

}

TY - JOUR

T1 - Do We Need Colonoscopy Following Acute Diverticulitis Detected on Computed Tomography to Exclude Colorectal Malignancy?

AU - Choi, Young Hoon

AU - Ko, Seongjoon

AU - Kim, Ji Won

AU - Kim, Byeong Gwan

AU - Lee, Kook Lae

AU - Im, Jong Pil

AU - Kim, Joosung

AU - Jung, Hyun Chae

PY - 2014/9/1

Y1 - 2014/9/1

N2 - Background: Although colonoscopy verification is warranted after an acute event of diverticulitis to exclude underlying malignancy, little evidence is available to support the recommendations. Aim: The aim of this study was to examine whether subsequent colonoscopy is warranted in patients with diverticulitis on computed tomography (CT). Methods: The study was composed of patients diagnosed with acute diverticulitis on CT scan from January 2001 to March 2013. Patients who had subsequent colonoscopy within a year from the date of CT were included. For each diverticulitis case, two age- (±5 years) and sex-matched controls were identified from healthy individuals who had received screening colonoscopy. We evaluated the diagnostic yield of advanced colonic neoplasia in colonoscopy. Results: One hundred and forty-nine patients underwent subsequent colonoscopy within a year from the date of CT. Among the patients, 11 (7.4 %) had colon cancer and 5 (3.4 %) had advanced adenoma. A case–control study revealed that the odds of detecting an advanced neoplasia among patients with diverticulitis on CT were approximately 8.8 times greater than in the age- and sex-matched controls [OR 8.84; 95 % CI 2.90–26.96; p < 0.001]. On analysis of the diverticulitis group, age (≥50 years) is an independent risk factor for detecting advanced colonic neoplasia. Conclusions: The yield of advanced colonic neoplasia was substantially higher in patients with acute diverticulitis than in asymptomatic, average-risk individuals. Colonoscopy verification is warranted in patients with diverticulitis detected on CT, especially in those aged 50 years or older.

AB - Background: Although colonoscopy verification is warranted after an acute event of diverticulitis to exclude underlying malignancy, little evidence is available to support the recommendations. Aim: The aim of this study was to examine whether subsequent colonoscopy is warranted in patients with diverticulitis on computed tomography (CT). Methods: The study was composed of patients diagnosed with acute diverticulitis on CT scan from January 2001 to March 2013. Patients who had subsequent colonoscopy within a year from the date of CT were included. For each diverticulitis case, two age- (±5 years) and sex-matched controls were identified from healthy individuals who had received screening colonoscopy. We evaluated the diagnostic yield of advanced colonic neoplasia in colonoscopy. Results: One hundred and forty-nine patients underwent subsequent colonoscopy within a year from the date of CT. Among the patients, 11 (7.4 %) had colon cancer and 5 (3.4 %) had advanced adenoma. A case–control study revealed that the odds of detecting an advanced neoplasia among patients with diverticulitis on CT were approximately 8.8 times greater than in the age- and sex-matched controls [OR 8.84; 95 % CI 2.90–26.96; p < 0.001]. On analysis of the diverticulitis group, age (≥50 years) is an independent risk factor for detecting advanced colonic neoplasia. Conclusions: The yield of advanced colonic neoplasia was substantially higher in patients with acute diverticulitis than in asymptomatic, average-risk individuals. Colonoscopy verification is warranted in patients with diverticulitis detected on CT, especially in those aged 50 years or older.

KW - Adenoma

KW - Colon cancer

KW - Colonoscopy

KW - Diverticulitis

UR - http://www.scopus.com/inward/record.url?scp=84907877088&partnerID=8YFLogxK

U2 - 10.1007/s10620-014-3151-1

DO - 10.1007/s10620-014-3151-1

M3 - Article

C2 - 24723071

AN - SCOPUS:84907877088

VL - 59

SP - 2236

EP - 2242

JO - Digestive diseases and sciences

JF - Digestive diseases and sciences

SN - 0163-2116

IS - 9

ER -