Routine colonic endoscopic evaluation following resolution of acute diverticulitis: Is it necessary?

Table 1 Summary of articles n (%)

	Year	Patients	Endoscopies	Patients with nonmalignant colonic polyps/neoplasia	Patients with malignancy	Comments
Krones et al[32]	2006	512	NR	NR	28 (5.5)	Looked at patients with malignancy and synchronous diverticulosis and patients with diverticulosis/diverticulitis and synchronous or metachronous malignancy
Lam et al[33]	2010	288	NR	23 (8)	5 (1.7)	Looked at all patients with diverticulitis. Reviewed pathology report for those undergoing resection
Lau et al[34]	2011	1088	319 (29.3)	82 (26)	9 (2.8)	Recommend routine colonic evaluation, especially in patients with complicated diverticulitis
Brar et al[35]	2013	458	249 (54.4)	77 (30.9)	4 (1.6)	Age and abscess are independent predictors of malignancy on multivariate analysis
Elmi et al[36]	2013	1034	402 (38.9)	78 (19.4)	9 (2.2)	Also evaluated CT findings and risk of malignancy
Total:				260 (20.7)	55 (3.1)

For reference, lifetime risk of non-malignant neoplastic lesions and malignancy is about 20% and 4%-5%, respectively. CT: Computed tomography; NR: Not recorded.

Table 2 Recent systematic reviews n (%)

	Year	Included articles	Patients	Endoscopies	Patients with nonmalignant colonic polyps/neoplasia	Patients with malignancy	Comments
Sai et al[37]	2012	10	771	430 (55.8)	NR	14 (2.1)	Patients evaluated within 24 wk with surgery, colonoscopy, or barium enema
Sharma et al[38]	2014	11	3358	1970 (58.7)	220 (19.5)	22 (1.6)	Also examined uncomplicated vs complicated diverticulitis and found proportional estimate of risk of 0.7% and 10.8%, respectively
de Vries et al[39]	2014	9	2490	1468 (59)	278 (19.9)	17 (1.16)	Only examined patients presenting with uncomplicated diverticulitis
Daniels et al[40]	2014	8	1796	1796 (100)1	363 (20.2)	29 (1.6)

¹Study only documented the patients who underwent endoscopy and did not document those who did not have endoscopy. For reference, lifetime risk of non-malignant neoplastic lesions and malignancy is about 20% and 4%-5%, respectively.