Is routine colonoscopy necessary for patients who have an unequivocal computerised tomography diagnosis of acute diverticulitis?
| Autor: | Adriel Chen, Hisham El Zanati, Abdulaziz Attiya, Edward Leung |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Emergency Medical Services medicine.medical_specialty Colon Colorectal cancer Aftercare Colonoscopy Unnecessary Procedures 03 medical and health sciences Patient Admission 0302 clinical medicine medicine Humans Ct diagnosis 030212 general & internal medicine Diverticulitis Aged Retrospective Studies Colorectal malignancy Aged 80 and over Clinical Audit Acute diverticulitis medicine.diagnostic_test business.industry Incidence Incidence (epidemiology) General Medicine Middle Aged medicine.disease Acute Disease Female 030211 gastroenterology & hepatology Radiology Tomography Colorectal Neoplasms Tomography X-Ray Computed business |
| Zdroj: | Scottish Medical Journal. 66:11-15 |
| ISSN: | 2045-6441 0036-9330 |
| Popis: | Aims To assess the incidence of underlying colorectal malignancy in patients admitted as an emergency with a CT diagnosis of acute diverticulitis and determine the need for routine follow up colonoscopy Methods A retrospective study was performed on all patients who had been admitted to our surgical unit with CT diagnosed diverticulitis from September 2016 to September 2018 (n = 125). Results 11 patients (8.8%) required emergency resection with no underlying malignancy found. 76 patients (61%) had a follow up colonoscopy after being discharged. 4 patients were found to have an underlying colorectal malignancy, one of them suspected on CT and another an incidentally detected caecal polyp cancer. Therefore 3/87(3.4%) had an unexpected cancer diagnosis and all those in the diseased segment were within complicated diverticulitis. Conclusion Nowadays, multi-slice CT scanners are so good at giving an accurate assessment of colonic pathology. In our study, 96.6% of the patients with a CT diagnosis of acute diverticulitis had no underlying malignancy in the diseased segment with all the cancers within complicated diverticulitis. With such a low yield of underlying malignancy in uncomplicated diverticulitis, we question the need for routine follow up colonoscopy when there is no CT suspicion of malignancy in these patients |
| Databáze: | OpenAIRE |
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