TPW 2.14 Colonoscopy After Acute Diverticulitis: Low Yield in Uncomplicated Disease, Higher Risk in Complicated Cases
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ID: 324068
2026
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Abstract
Abstract Background The role of routine colonoscopy after acute diverticulitis remains uncertain, with recent guidelines increasingly advocating a selective, risk-based approach. This study evaluated the diagnostic yield of colonoscopy following diverticulitis and examined the impact of disease complexity on colorectal neoplasia detection. Methods A retrospective analysis was conducted of 268 patients with CT-confirmed acute diverticulitis. Colonoscopy was performed in 167 patients (62.3%). Patients were classified as having uncomplicated or complicated diverticulitis based on radiological and clinical criteria. Colonoscopic findings were categorized as diverticulosis, benign polyps, strictures, colorectal cancer, or normal mucosa. The association between disease complexity and colonoscopic findings was assessed using chi-square testing. Results Among the 167 patients who underwent colonoscopy, the predominant finding was diverticulosis (82.0%), followed by benign polyps (6.0%), strictures (2.4%), and a single colorectal cancer (0.6%); 9.0% had a normal examination. Of these, 114 patients had uncomplicated and 53 had complicated diverticulitis. All malignant pathology occurred in the complicated group, yielding a cancer detection rate of 1.9% in complicated versus 0% in uncomplicated diverticulitis. Benign polyps were similarly distributed between groups, whereas strictures were more frequent in complicated disease, and normal colonoscopy was more common after uncomplicated episodes. Conclusion Colonoscopy after uncomplicated diverticulitis demonstrated a very low diagnostic yield for colorectal cancer, while malignancy occurred exclusively in patients with complicated disease. These findings support a selective strategy, prioritising colonoscopy for complicated diverticulitis or additional risk factors, rather than universal post-diverticulitis endoscopic evaluation.
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openalex_W7172516765
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| Authors | Ahmed Gerwash, Jia Hui Loo, Najiyah Khanom, Jane Lai, Stephen Agboro, Ahmed Hammad |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag087.312
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| URL | |
| Keywords | Keywords not found |
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