TPT 1.01 Less Is More: Evaluating The Role of Sigmoidoscopy Versus Colonoscopy After Acute Uncomplicated Diverticulitis
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ID: 324051
2026
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Abstract
Abstract Introduction Despite high incidence of hospitalisations with acute diverticulitis, there remain conflicting recommendations regarding post-episodic colonic evaluation in international guidelines. This study aims to assess the clinical benefit of colonic evaluation with a view to influence local policy concerning the use of colonoscopy vs sigmoidoscopy post-resolution of acute diverticulitis. Design A retrospective study of patients admitted with acute diverticulitis in a tertiary referral centre in the Republic of Ireland between January 2023 and December 2024. Patients were divided into four groups: colonoscopy, flexible sigmoidoscopy, non-endoscopic colonic surveillance and no colonic surveillance. Outcome measures included rate of colon cancer detection, polyp detection rate and location. Results 254 diverticulitis-related admissions were identified; 88 (34.7%) met the inclusion criteria of CT-confirmed acute uncomplicated diverticulitis. 69 patients underwent colonic evaluation. No complications were encountered. Colonic polyps were identified in 16/69 (23.2%) of patients (adenomatous: 11/69, 15.9%; hyperplastic: 8/69, 11.6%; unknown histology: 1/69, 1.5%; both subtypes: 4/69, 5.8%). The majority of these polyps (9/16; 56%) were found beyond the sigmoid colon; 6/16 (38%) of these patients would have been eligible for Ireland's National Bowel Screening Programme. No cancerous polyps were detected. Conclusion Colonic evaluation following CT-confirmed acute uncomplicated diverticulitis over a two-year period yielded only modest polyp detection rates, comparable to average population-based screening. These findings corroborate a growing body of evidence that challenges the dogma of routine colonoscopy after acute uncomplicated diverticulitis. This is supportive of a case-by-case approach as a more targeted, resource-conscious strategy.
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| Authors | Diana Griniouk, Niamh Dundon, Dara Kavanagh |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag087.157
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| URL | |
| Keywords | Keywords not found |
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