Screening for colorectal neoplastic lesions following acute diverticulitis:Would a sigmoidoscopy suffice?

• 作者: Cecilia Innes-Wong Edward J Travers Leong Ung Tiong Randall Williams Ryan Jalleh Savio G Barreto Thomas Paxton
• 来源期刊: 世界外科手术杂志
• 学科: 医学
• 关键词: POLYPS Surgery DIVERTICULITIS COLONOSCOPY COLORECTAL cancer
• 年，卷（期）: sjwksszz,（2）
• 页码范围: 13-17
• 页数: 5页
• 分类号: R

摘要

AIM:To investigate the yield of colorectal malignant or premalignant lesions during colonoscopy performed following an episode of acute diverticulitis.METHODS:A prospectively maintained electronic database of a public teaching hospital(Modbury Hospital,South Australia)was searched for international classification of diseases codes for acute diverticulitis from July 2007 to June 2011.The electronic database and each patient’s medical records were reviewed for demographic data,clinical presentation,investigation results,colonoscopy details and surgical intervention.RESULTS:Two hundred and nineteen patients were diagnosed with acute diverticulitis with a median age of 60 years(range 24-93).One hundred and thirty-nine patients(63.5%)had follow-up screening colonoscopy,with the median interval between the episode of acute diverticulitis and colonoscopy being 8 wk(range:1-66).Colonoscopy revealed polyps in 21 patients(15%)and no cases of colorectal cancer.Of the 21 patients with polyps,there were 14 patients(10%)with tubular/villous adenomas(13 in rectosigmoid region and 1 in descending colon).CONCLUSION:Detection of colorectal cancer in patients undergoing routine colonoscopy following acute diverticulitis is rare.However,colonic polyps in the left colon are noted.A flexible sigmoidoscopy is an adequate screening tool in such patients.A complete colonoscopy reserved for patients with family history of colorectal cancer or with polyps detected on flexible sigmoidoscopy to evaluate the rest of the colon.