Dedrick Kok Hong Chan1, Ker-Kan Tan1,2. 1. Division of Colorectal Surgery, University Surgical Cluster, National University Health System, National University of Singapore, Singapore. 2. Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Abstract
BACKGROUND: Colonoscopy is advocated following acute diverticulitis to ensure that malignancy is not missed. In an Asian population, diverticulitis is more common in the right colon and in younger patients. The purpose of this study is to examine the utility of colonoscopy amongst Asian patients <50 years of age who have had colonic diverticulitis. METHODS: A retrospective review of all patients aged 50 years and under who were treated for colonic diverticulitis between 2012 and 2014 was performed. All patients were advised to undergo a colonoscopy when the diverticulitis had settled, and findings at colonoscopy were recorded. RESULTS: Fifty-five patients aged <50 years had acute diverticulitis. Forty-eight (87.3%) had right-sided diverticulitis. Amongst them, 45 (93.8%) had Hinchey 1a, 1b or 2 diverticulitis, while none had Hinchey 4 diverticulitis. Excluding the only patient that underwent a colonic resection, 27 (50.0%) patients returned for a colonoscopy. None of these patients were found to have colorectal cancer or an advanced adenoma. Six (11.1%) of them had adenomas with low-grade dysplasia. CONCLUSION: Right-sided diverticulitis is more common in the young Asian population. Most patients can be conservatively treated. Follow-up colonoscopy may not be required in these patients.
BACKGROUND: Colonoscopy is advocated following acute diverticulitis to ensure that malignancy is not missed. In an Asian population, diverticulitis is more common in the right colon and in younger patients. The purpose of this study is to examine the utility of colonoscopy amongst Asian patients <50 years of age who have had colonic diverticulitis. METHODS: A retrospective review of all patients aged 50 years and under who were treated for colonic diverticulitis between 2012 and 2014 was performed. All patients were advised to undergo a colonoscopy when the diverticulitis had settled, and findings at colonoscopy were recorded. RESULTS: Fifty-five patients aged <50 years had acute diverticulitis. Forty-eight (87.3%) had right-sided diverticulitis. Amongst them, 45 (93.8%) had Hinchey 1a, 1b or 2 diverticulitis, while none had Hinchey 4 diverticulitis. Excluding the only patient that underwent a colonic resection, 27 (50.0%) patients returned for a colonoscopy. None of these patients were found to have colorectal cancer or an advanced adenoma. Six (11.1%) of them had adenomas with low-grade dysplasia. CONCLUSION: Right-sided diverticulitis is more common in the young Asian population. Most patients can be conservatively treated. Follow-up colonoscopy may not be required in these patients.
Entities:
Keywords:
Colorectal cancer; Diverticulitis; Screening for malignancy
Authors: Kartik S Jhaveri; Mukesh G Harisinghani; Jack Wittenberg; Sanjay Saini; Peter R Mueller Journal: J Comput Assist Tomogr Date: 2002 Jan-Feb Impact factor: 1.826
Authors: R Fante; P Benatti; C di Gregorio; S De Pietri; M Pedroni; M G Tamassia; A Percesepe; G Rossi; L Losi; L Roncucci; M Ponz de Leon Journal: Am J Gastroenterol Date: 1997-09 Impact factor: 10.864
Authors: Daniel Feingold; Scott R Steele; Sang Lee; Andreas Kaiser; Robin Boushey; W Donald Buie; Janice Frederick Rafferty Journal: Dis Colon Rectum Date: 2014-03 Impact factor: 4.585
Authors: Nicolle M Gatto; Harold Frucht; Vijaya Sundararajan; Judith S Jacobson; Victor R Grann; Alfred I Neugut Journal: J Natl Cancer Inst Date: 2003-02-05 Impact factor: 13.506
Authors: Nicholas Yock Teck Soh; Daryl Kai Ann Chia; Nan Zun Teo; Calvin Jian Ming Ong; Ramesh Wijaya Journal: Int J Colorectal Dis Date: 2018-04-16 Impact factor: 2.571