Role of colonoscopy in patients with persistent acute diverticulitis.
OBJECTIVE
To identify patients with persistent acute diverticulitis who might benefit from an early colonoscopy during their first hospitalization.


METHODS
All patients hospitalized between July 2000 and December 2006 for acute diverticulitis who underwent colonoscopy were included in the study. Patients were followed during hospitalization and after discharge. Patients were considered to have a persistent course of acute diverticulitis if symptoms continued after 1 wk of conventional treatment with IV antibiotics, or if symptoms recurred within 2 mo after discharge. Patients were considered to benefit from an early colonoscopy if the colonoscopy was therapeutic or if it changed a patient's outcome.


RESULTS
Three hundred and six patients were hospitalized between July 2000 and December 2006 with the diagnosis of acute diverticulitis. Two hundred and twenty four of these were included in the study group. Twenty three patients (10.3%) fulfilled the criteria for a persistent course of acute diverticulitis. Of them, four patients (17.4%) clearly benefited from an early colonoscopy; these patients' clinical course is described. None of the patients with a regular non-persistent course demonstrated any benefit from colonoscopy.


CONCLUSIONS
Early colonoscopy detected other significant pathology, which accounted for the clinical presentation in 17% of patients with persistent acute diverticulitis. Therefore, we believe an early colonoscopy should be considered in all patients with a persistent clinical course.
Lahat
Adi
A
Department of Gastroenterology, Chaim Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Yanai
Henit
H
Sakhnini
Emad
E
Menachem
Yoram
Y
Bar-Meir
Simon
S
D000208:Acute Disease; D000230:Adenocarcinoma / Q000473:pathology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003110:Colonic Neoplasms / Q000473:pathology*; D003113:Colonoscopy; D004239:Diverticulitis, Colonic / Q000188:drug therapy / Q000473:pathology*; D005549:Foreign-Body Reaction / Q000473:pathology*; D006760:Hospitalization; D006801:Humans; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure
D000900:Anti-Bacterial Agents