Ariam E, Richter V, Bermont A, Sandler Y, Cohen DL, Shirin H. Prior abdominal surgery as a potential risk factor for colonic diverticulosis or diverticulitis. World J Clin Cases 2023; 11(35): 8320-8329 [PMID: 38130607 DOI: 10.12998/wjcc.v11.i35.8320]
Corresponding Author of This Article
Daniel L Cohen, MD, Gastroenterologist, The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir Medical Center, Zerifin 70300, Israel. docdannycohen@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 16, 2023; 11(35): 8320-8329 Published online Dec 16, 2023. doi: 10.12998/wjcc.v11.i35.8320
Prior abdominal surgery as a potential risk factor for colonic diverticulosis or diverticulitis
Eran Ariam, Vered Richter, Anton Bermont, Yael Sandler, Daniel L Cohen, Haim Shirin
Eran Ariam, Department of Gastroenterology, Kaplan Medical Center, Rehovot 76100, Israel
Vered Richter, Anton Bermont, Daniel L Cohen, Haim Shirin, The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir Medical Center, Zerifin 70300, Israel and the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Yael Sandler, Department of Surgery Division, Shamir Medical Center, Zerifin 70300, Israel
Author contributions: Shirin H designed the research study; Ariam E, Richter V, Bermont A and Sandler Y performed the research; Ariam E, Cohen DL and Shirin H analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Helsinki Committee of Shamir Medical Center (0107-20-ASF).
Informed consent statement: All study participants provided informed consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE statement--checklist of items, and the manuscript was prepared and revised according to the STROBE statement--checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Daniel L Cohen, MD, Gastroenterologist, The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir Medical Center, Zerifin 70300, Israel. docdannycohen@yahoo.com
Received: September 18, 2023 Peer-review started: September 18, 2023 First decision: November 13, 2023 Revised: November 15, 2023 Accepted: December 4, 2023 Article in press: December 4, 2023 Published online: December 16, 2023 Processing time: 86 Days and 19.2 Hours
ARTICLE HIGHLIGHTS
Research background
Diverticulosis coli is one of the leading causes of morbidity in Western countries. Abnormal colonic pressure profiles have been associated with an increased risk of colonic diverticulosis.
Research motivation
Despite its high prevalence, the pathogenesis of colonic diverticulosis remains poorly understood.
Research objectives
We sought to assess whether previous abdominal surgery, presumably by means of adhesion-related increased colonic intraluminal pressure, is associated with colonic diverticulosis or diverticulitis.
Research methods
Patients undergoing colonoscopy completed a structured questionnaire concerning previous abdominal surgeries, dietary and lifestyle exposures including smoking and alcohol use, and co-morbidities. The presence of diverticulosis was identified via colonoscopy.
Research results
Three hundred and fifty-nine patients were included in the study. The overall prevalence of colonic diverticulosis was 25% (91/359) and 48% of the patients had previous abdominal surgery. There was no difference in the rate of previous abdominal surgery between patients with or without diverticulosis (49% vs 47%, P = 0.78). In regards to specific surgeries, inguinal hernia repair was significantly associated with diverticulosis (52% vs 20%, P = 0.001), but not diverticulitis. In contrast, appendectomy was not associated with diverticulosis (6% vs 14%, P = 0.048).
Research conclusions
These findings suggest that post-operative abdominal adhesions inducing high colonic intraluminal pressures do not appear to be the mechanism for diverticula formation. Rather, inguinal hernia and diverticulosis may share similar connective tissue pathologies with no causative relationship between them.
Research perspectives
The pathogenesis of colonic diverticulosis remains unclear and future studies are needed.
