Thursday, August 8, 2019

All patients should undergo colonoscopy after acute diverticulitis

Dr KK Aggarwal

Routine colonoscopy is usually recommended following an episode of acute diverticulitis to rule out coexistent malignancy. Although it continues to be recommended in guidelines, CT imaging has gradually taken over.

In a meta-analysis on the role of colonoscopy after an episode of left-sided acute diverticulitis, colorectal cancer was detected in 2.1% (95% CI 1.5-3.1) of patients. This risk is higher than the 0.4-1.0% prevalence of colorectal cancer in the general population who undergo screening colonoscopy.

These findings suggest that all patients, especially those with complicated disease or ongoing symptoms should undergo colonoscopy after an episode of acute diverticulitis, unless the procedure was performed in the previous year. The results of the meta-analysis are published in July 2019 issue of the British Journal of Surgery.

(Ref: Rottier SJ, et al. Meta-analysis of the role of colonoscopy after an episode of left-sided acute diverticulitis. Br J Surg. 2019 Jul;106(8):988-97).

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA

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