Abstract
BackgroundRoutine colonoscopy is recommended to determine the coexistence of colon cancer after medical treatment for colon diverticulitis. However, in the case of uncomplicated diverticulitis diagnosed by computed tomography, the clinical relevance of routine follow-up colonoscopy has recently been debated. Yet, the role of follow-up colonoscopy for right colon diverticulitis, which tends to develop at a younger age than left colon diverticulitis, has not been specifically evaluated. Therefore, we aimed to evaluate the incidence of right colon cancer or colonic adenomatous polyps, detected by routine colonoscopy, after conservative management of acute uncomplicated right colon diverticulitis.MethodsPatients with uncomplicated right colon diverticulitis (modified Hinchey stage Ia) diagnosed by computed tomography imaging, between 2011 and 2017, and who underwent follow-up colonoscopy surveillance after treatment were included. The primary outcome was the incidence of colon cancer, with the detection rate of adenoma being the secondary outcome. Information for analysis was retrieved retrospectively from patients’ medical records.Results The study group included 330 consecutive patients, with a mean age of 41.9 years, and 51.9% being men. For the primary outcome, the rate of colon cancer on follow-up colonoscopy was 0.3% (1/330 cases). The rate of adenoma detection was 20.9% (69/330 cases) and advanced adenoma (> 10 mm in diameter; or exhibiting a > 25% villous component or severe dysplasia), including colon cancer, was observed in 9 patients (2.7%).ConclusionsIn patients with acute uncomplicated right colonic diverticulitis, routine colonoscopy after conservative treatment may be necessary because although the colon cancer detection rate is low, it is possible to detect advanced colon adenoma.
Highlights
Routine colonoscopy is recommended to determine the coexistence of colon cancer after medi‐ cal treatment for colon diverticulitis
Lee et al BMC Gastroenterol (2021) 21:91 be important as right-sided colon diverticulitis tends to occur at a younger age than left-sided colon diverticulitis, with a low stage Hinchey classification being common on computed tomography (CT) [4]
We retrospectively reviewed the electronic medical records of patients diagnosed with acute right-sided colon diverticulitis, between January 2011 and December 2017, at our hospital
Summary
Routine colonoscopy is recommended to determine the coexistence of colon cancer after medi‐ cal treatment for colon diverticulitis. We aimed to evaluate the incidence of right colon cancer or colonic adenomatous polyps, detected by routine colonoscopy, after conservative management of acute uncompli‐ cated right colon diverticulitis. The onset of colon cancer at a younger age is more likely to occur in the left than right colon [6] Considering these points, it is unclear how routine colonoscopy evaluation after right colon diverticulitis could be of clinical benefit with regard to diagnostic performance and economic burden. The aim of our study was to evaluate the incidence of right colon cancer and colonic adenomatous polyps by routine colonoscopy, after conservative management of acute uncomplicated right colon diverticulitis
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