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PTU-238 Is colonoscopy following an episode of uncomplicated diverticulitis necessary?
  1. J Younis,
  2. S Everett,
  3. P Nisar,
  4. J Trickett
  1. Ashford and St. Peter’s NHS Trust, Surrey, UK

Abstract

Introduction Colonoscopy following an episode of acute uncomplicated diverticulitis is routinely practiced in many colorectal units. Internationally recognised guidelines advocate colonoscopy to confirm the diagnosis and exclude neoplasia. The evidence to suppot this is minimal. The aim here was to determine the incidence of colonic neoplasia identified at colonoscopy following an episode of uncomplicated diverticulitis in our unit.

Method A retrospective study was conducted on patients admitted with CT confirmed uncomplicated diverticulitis over a period of 4 years within one trust. All patients included underwent a colonoscopy within 1 year of presentation.

The main outcome measure was the incidence of invasive malignancy/advanced adenoma on colonoscopy performed within 1 year of admission

Results Two hundred and seventy-three patients were admitted with uncomplicated diverticulitis over a period of 4 years. Two hundred and thirty-seven of these underwent colonoscopy within 1 year of admission. Seventy one (30%) patients had colonic polyps, nine (4.1%) patients had advanced adenomas and two patients were found to have an invasive malignancy. Eleven patients (4.9%) were therefore found to have neoplasia. According to age category (under the age of 50 versus over the age of 50), all cases of neoplasia were found to be present in the older age group. This was statistically significant (p < 0.05).

Conclusion Patients found to have neoplasia at colonoscopy following an episode of uncomplicated diverticulitis here was 4.9%. This is no higher than the incidence of colonic neoplasia amongst the average population. Routinely performing colonoscopy after acute uncomplicated diverticulitis may therefore not be necessary.

Disclosure of interest None Declared.

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