NDLI: Routine Endoscopy After Acute Sigmoid Diverticulitis: Would a Sigmoidoscopy be Sufficient?

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Routine Endoscopy After Acute Sigmoid Diverticulitis: Would a Sigmoidoscopy be Sufficient?

Content Provider	Europe PMC
Author	Hannan, Enda Harding, Tim Duggan, William Brosnan, Conor Maguire, Donal
Editor	Muacevic, Alexander Adler, John R
Copyright Year	2021
Abstract	Background Current guidelines suggest that patients should undergo colonoscopy after CT confirmed acute diverticulitis to outrule colorectal cancer (CRC). The aim of this study was to determine if flexible sigmoidoscopy (FS) could be a viable alternative to full colonoscopy following acute sigmoid diverticulitis. Methods A retrospective study of 271 patients was performed who were diagnosed with acute sigmoid diverticulitis by CT and subsequently underwent full colonoscopy. Medical records, CT reports, endoscopy reports, and histopathological reports were reviewed. Results Sigmoid diverticulosis was confirmed on colonoscopy in all patients. No colorectal malignancies were detected. Adenomatous polyps were found in 16 (5.9%) patients, of which three had polyps detected beyond the sigmoid colon. The overall proportion of abnormalities found beyond the sigmoid colon was 1.1% (n=3). Conclusion The detection of CRC cancer in patients undergoing full colonoscopy following an episode of acute sigmoid diverticulitis is rare. Despite this, current guidelines still advocate for endoscopy due to the potentially serious consequences of a missed malignancy. However, given that the area of concern in these cases is the sigmoid colon, FS may be a feasible means of outruling malignancy in the absence of red flag features that would necessitate a full colonoscopy. Our results support this approach, with no CRC detected and a polyp detection rate equivalent to that of the general population. This offers numerous advantages to a full colonoscopy for the patient and health service by being a quicker, cheaper, safer procedure without the need for full bowel preparation or IV sedation.
Journal	Cureus
Volume Number	13
DOI	10.7759/cureus.17648
PubMed Central reference number	PMC8486147
Issue Number	9
PubMed reference number	34646695
e-ISSN	21688184
Language	English
Publisher	Cureus
Publisher Date	2021-09-01
Publisher Place	Palo Alto (CA)
Access Restriction	Open
Subject Keyword	sigmoid diverticulitis colorectal cancer colonoscopy sigmoidoscopy diverticulitis
Content Type	Text
Resource Type	Article
Subject	Medicine

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Routine Endoscopy After Acute Sigmoid Diverticulitis: Would a Sigmoidoscopy be Sufficient?

Background

Methods

Results

Conclusion