Diverticular Disease
The American College of Gastroenterology guidelines recommend colonic evaluation after resolution of clinically diagnosed diverticulitis to exclude other diagnostic considerations, particularly cancer. Because of the potential for perforation as a result of the microabscess that presumably caused acute diverticulitis, the examination typically is postponed for at least 6 weeks.
There is an increased risk of colon cancer in the first year after a diagnosis of diverticular disease. A population-based, case-control study of 41,037 patients with colon cancer found an increased odds ratio of 25 (95% confidence interval, 17–38) of a colon cancer diagnosis within 6 months of an admission for diverticular disease. There was no association with a colon cancer diagnosis 12 months after the admission for diverticular disease. The increased risk of colon cancer within 12 months of an admission for diverticular disease was attributed to surveillance bias and misclassification.
If a patient has had a recent colonoscopy before developing acute diverticulitis, whether there is any use in a repeat endoscopic examination is unknown. Lau et al found a number of cancers and other significant lesions when they performed a colonoscopy after an acute attack of diverticulitis. However, they excluded patients who had a colonoscopy within a year, and therefore recommended only performing colonoscopic examinations for individuals who had not had a recent radiologic or endoscopic colonic examination.
A colonoscopy should be performed to exclude colon cancer after an initial episode of suspected diverticulitis. If a patient has had a recent colonoscopy before developing acute diverticulitis, the value of a repeat colonoscopy to exclude cancer is unknown.
Colonoscopy
The American College of Gastroenterology guidelines recommend colonic evaluation after resolution of clinically diagnosed diverticulitis to exclude other diagnostic considerations, particularly cancer. Because of the potential for perforation as a result of the microabscess that presumably caused acute diverticulitis, the examination typically is postponed for at least 6 weeks.
There is an increased risk of colon cancer in the first year after a diagnosis of diverticular disease. A population-based, case-control study of 41,037 patients with colon cancer found an increased odds ratio of 25 (95% confidence interval, 17–38) of a colon cancer diagnosis within 6 months of an admission for diverticular disease. There was no association with a colon cancer diagnosis 12 months after the admission for diverticular disease. The increased risk of colon cancer within 12 months of an admission for diverticular disease was attributed to surveillance bias and misclassification.
If a patient has had a recent colonoscopy before developing acute diverticulitis, whether there is any use in a repeat endoscopic examination is unknown. Lau et al found a number of cancers and other significant lesions when they performed a colonoscopy after an acute attack of diverticulitis. However, they excluded patients who had a colonoscopy within a year, and therefore recommended only performing colonoscopic examinations for individuals who had not had a recent radiologic or endoscopic colonic examination.
A colonoscopy should be performed to exclude colon cancer after an initial episode of suspected diverticulitis. If a patient has had a recent colonoscopy before developing acute diverticulitis, the value of a repeat colonoscopy to exclude cancer is unknown.
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