CT colonography versus colonoscopy in the follow-up of patients after diverticulitis - a prospective, comparative study.
OBJECTIVE
To assess whether computed tomography colonography (CTC) is a viable alternative to colonoscopy or double contrast barium enema in the follow-up of patients after diverticulitis.


METHODS
Fifty patients underwent CTC followed immediately by colonoscopy. Results were blinded to the examiners. Findings of diverticular disease and patient acceptance were evaluated.


RESULTS
Bowel preparation and distension were good in the majority of CTC and colonoscopy examinations. Diverticular disease was found in 96% of patients at CTC and in 90% at colonoscopy. The rate of agreement between CTC and colonoscopy for diverticular findings in the sigmoid colon was good (kappa=0.64). No complications were seen. Patients found colonoscopy more uncomfortable (p<0.03), more painful (p<0.001), and more difficult (p<0.01) than CTC. Of the patients favouring one examination, 74% preferred CTC.


CONCLUSIONS
CTC appears to have a better diagnostic potential for imaging of diverticular disease-specific findings, when compared with colonoscopy. Also, CTC was less uncomfortable and was preferred by a majority of patients. CTC seems to be a reasonable alternative in follow-up of patients with symptomatic diverticular disease.
Hjern
F
F
Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institut, Stockholm, Sweden. fredrik.hjern@ds.se
Jonas
E
E
Holmström
B
B
Josephson
T
T
Mellgren
A
A
Johansson
C
C
D000328:Adult; D000368:Aged; D003108:Colonic Diseases / Q000175:diagnosis*; D023881:Colonography, Computed Tomographic / Q000592:standards*; D003113:Colonoscopy / Q000592:standards*; D004238:Diverticulitis / Q000175:diagnosis*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D012680:Sensitivity and Specificity