Intestinal Research

Original Article

Is Colonoscopy Necessary after Computed Tomography Diagnosis of Acute Diverticulitis?: Min Jung Kim, Young Sik Woo, Eun Ran Kim, Sung Noh Hong, Dong Kyung Chang, Poong-Lyul Rhee, Jae J. Kim, Soon Jin Lee, Young-Ho Kim; Intest Res 2014;12(3):221-228. Published online July 25, 2014; DOI: https://doi.org/10.5217/ir.2014.12.3.221

<b>Background/Aims</b><br/>

A diagnosis of acute diverticulitis is based on computed tomography (CT). Colonoscopy is commonly performed after the acute event to exclude other diagnoses. This study aimed to determine whether colonoscopy is necessary and what additional information is gained from a colonoscopy after acute diverticulitis.

Methods

Acute diverticulitis was diagnosed by clinical criteria and characteristic CT findings. We analyzed the number of patients in whom colorectal cancers were diagnosed and other incidental findings of polyps and other diseases.

Results

A total of 177 patients were analyzed retrospectively. The mean age was 43.3±15.3 years (range, 13-82 years) and 97 patients (54.8%) were male. Sixty-one patients had undergone a colonoscopy within 1 year of the acute attack. Advanced adenomatous lesions and colonic malignancy were not detected. Nineteen patients (31.1%) had ≥1 polyp and 11 patients (18.0%) had an adenomatous polyp. No new or different diagnosis was made after colonoscopy. None of the 116 patients who did not undergo colonoscopy within a year after acute diverticulitis had a diagnosis of colorectal cancer registered with the Korea Central Cancer Registry.

Conclusions

Routine colonoscopy yields little benefit in patients with acute diverticulitis diagnosed by typical clinical symptoms and CT. The current practice of a colonoscopy after acute diverticulitis needs to be reevaluated.

Citations

Citations to this article as recorded by

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Risk for colorectal cancer after computed tomography verified acute diverticulitis: A retrospective cohort study with long-term follow-up
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Diagnosis and management of acute colonic diverticulitis: results of a survey among Korean gastroenterologists
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Comparative outcomes of acute colonic diverticulitis in immunocompromised versus immunocompetent patients: a systematic review and meta-analysis
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Intestinal Research.2023; 21(4): 481. CrossRef
Diagnosis and Treatment of Colonic Diverticular Disease
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The Korean Journal of Gastroenterology.2022; 79(6): 233. CrossRef
Diverticulitis does not increase the long-term risk of developing colon cancer: a systematic review and meta-analysis
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International Journal of Colorectal Disease.2022; 37(9): 1945. CrossRef
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Systematic Review and Meta-analysis on Colorectal Cancer Findings on Colonic Evaluation After CT-Confirmed Acute Diverticulitis
Chee Hoe Koo, Jasmine H.E. Chang, Nicholas L. Syn, Ian J.Y. Wee, Ronnie Mathew
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Risk of Colorectal Cancer in Patients With Acute Diverticulitis: A Systematic Review and Meta-analysis of Observational Studies
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Clinical Gastroenterology and Hepatology.2019; 17(8): 1448. CrossRef
What radiologists should know about tomographic evaluation of acute diverticulitis of the colon
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High Probability of an Underlying Colorectal Cancer Among Patients Treated for Acute Diverticulitis. A Population‐Based Cohort Follow‐Up Study
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World Journal of Surgery.2016; 40(9): 2283. CrossRef
Colonoscopy after Hinchey I and II left-sided diverticulitis: utility or futility?
Avery S. Walker, Jason R. Bingham, Karmon M. Janssen, Eric K. Johnson, Justin A. Maykel, Omar Ocampo, John P. Gonzalez, Scott R. Steele
The American Journal of Surgery.2016; 212(5): 837. CrossRef

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94 Download
15 Web of Science
13 Crossref

Case Reports

Superior Mesenteric Vein Thrombosis as an Early Presentation of Myelodysplastic Syndrome: A Case Report: Min Jung Kim, Hyun Joo Song, Woo Kun Kim, Sun Hyung Kim; Intest Res 2014;12(2):157-161. Published online April 29, 2014; DOI: https://doi.org/10.5217/ir.2014.12.2.157

Abstract PDF PubReader

Mesenteric venous thrombosis (MVT) is a serious condition due to its potential association with mesenteric ischemia and infarction of the small bowel. Symptoms of MVT are often vague, making accurate diagnosis and sufficient treatment difficult. However, increased awareness and new imaging modalities for this condition have improved outcomes for patients with MVT. Treatment includes anticoagulation, transcatheter therapy, and surgery. In the present report, we describe the case study of a 62-year-old woman with a presenting diagnosis of superior MVT, who was finally diagnosed with myelodysplastic syndrome. The superior MVT spontaneously dissolved after the patient underwent 6 months of systemic anticoagulation therapy. Invasive surgery or bowel resection was not required.

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A Case of Malignant Lymphoma Discovered During Treatment of Superior Mesenteric Vein Thrombosis
Haruka Oi, Satoshi Yamamoto, Takafumi Akai, Masako Ogawa, Yukiyoshi Masaki
Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons).2017; 42(6): 1013. CrossRef
Acute Myocardial Infarction Caused by Thrombotic Microangiopathy Complicated With Myelodysplastic Syndrome
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International Heart Journal.2016; 57(5): 634. CrossRef

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65 Download
1 Web of Science
2 Crossref

A Case of Ischemic Colitis Presenting as Bloody Diarrhea after Glycerin Enema: Jong Min Yoon, Sang Hyun Kim, Jin Sook Lee, Min Jung Kim, Se Won Jang, Yang Jin Kim, Tae Young Jeon; Intest Res 2013;11(1):52-55. Published online January 31, 2013; DOI: https://doi.org/10.5217/ir.2013.11.1.52

Abstract PDF

Enema has frequently been used for diagnostic or therapeutic purpose. However, cases of colitis from physical, chemical, and thermal injury due to enema have been reported. In severe cases, life threatening complications (perforation, rupture, peritonitis, etc.) may occasionally occur. Reports of ischemic colitis after enema is rare and there have been only 1 case of ischemic colitis after normal saline enema reported in South Korea. Sigmoidoscopy on a 58 year old female, presenting with sudden abdominal pain and hematochezia after glycerin enema, revealed ischemic injury of the rectosigmoid colon, which was improved after using antibiotics and conservative therapy. (Intest Res 2013;11:52-55)

Citations

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Ischemic colitis after enema administration: Incidence, timing, and clinical features
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Korean Journal of Medicine.2015; 88(1): 15. CrossRef

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39 Download
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