Endoscopy 2018; 50(04): S178
DOI: 10.1055/s-0038-1637580
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

THE CLINICAL SIGNIFICANCE OF COLONOSCOPY IN THE PATIENTS WITH CT-DIAGNOSED ACUTE DIVERTICULITIS

MC Kim
1   Yeungnam University College of Medicine, Division of Gastroenterology, Department of Internal Medicine, Daegu, Korea, Republic of
,
SB Kim
1   Yeungnam University College of Medicine, Division of Gastroenterology, Department of Internal Medicine, Daegu, Korea, Republic of
,
KO Kim
1   Yeungnam University College of Medicine, Division of Gastroenterology, Department of Internal Medicine, Daegu, Korea, Republic of
,
KH Kim
1   Yeungnam University College of Medicine, Division of Gastroenterology, Department of Internal Medicine, Daegu, Korea, Republic of
,
SH Lee
1   Yeungnam University College of Medicine, Division of Gastroenterology, Department of Internal Medicine, Daegu, Korea, Republic of
,
BI Jang
1   Yeungnam University College of Medicine, Division of Gastroenterology, Department of Internal Medicine, Daegu, Korea, Republic of
,
TN Kim
1   Yeungnam University College of Medicine, Division of Gastroenterology, Department of Internal Medicine, Daegu, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

Also available ateRef
 

Aims:

International guideline recommends performing a colonoscopy after an episode of acute diverticulitis. The aim of this study was to assess the colonoscopy results and its clinical significance in patients with acute diverticulitis on CT scan.

Methods:

From January 2006 to December 2016, medical records of patients with acute diverticulitis diagnosed on CT scan who underwent complete colonoscopy within 1 year of diagnosis were reviewed retrospectively. Patient's characteristics, CT findings and colonoscopy results were reviewed. Analysis for prevalence and factors associated with advanced colorectal neoplasia (ACN) were also performed.

Results:

Among the 235 patients with acute diverticulitis diagnosed on CT scan, 77 patients without exclusion criteria were finally included. The mean age was 49.7 ± 15.3 years and 51 (66.2%) patients were men. The lesion was in the right colon in 68 (88.3%) patients and all the lesions were shown as bowel wall thickening on CT scan. Fluid collection was noted in 11 (14.3%) patients, abscess in 3 (3.9%) patients and lymphadenopathy in 7 (9.1%) patients on CT scan. 97.4% of the patients were improved with conservative treatment. Mean interval from diagnosis to colonoscopy was 40.2 ± 56.4 days. Adenomatous polyps were found in 19 (24.7%) patients, among them, 5 (6.5%) patients had advanced adenoma. Colorectal adenocarcinoma was found in 4 (5.2%) patients and all of them were over 70 years old. All the neoplastic lesions were detected in consistent with those on CT scan. The prevalence of advanced colorectal neoplasia was higher in patients over 60 years and admitted for longer than 10 days. On multivariate analysis, age over 60 years was identified as independent risk factor for ACN.

Conclusions:

Colonoscopy detected ACN in 11.7% patients with acute diverticulitis. Because patients over 60 years have a higher risk of ACN, follow-up colonoscopy is needed after the diagnosis of acute diverticulitis.