Early Colonoscopy Beneficial for Patients with CT-diagnosed Acute Diverticulitis

Patients with acute diverticulitis diagnosed by contrast-enhanced CT (CECT) may benefit from early colonoscopies for colon cancer screening, according to an article published in the American Journal of Roentgenology.

Researchers from Harvard Medical School studied endoscopic colonoscopy results of 402 patients who had been diagnosed with acute diverticulitis on CECT between January 2000 and December 2004. The goal of the study was to establish CT criteria as an indication for colonoscopy in this patient population.

The researchers evaluated the sensitivity, specificity, and predictive values of the imaging parameters for prediction of colon cancer. The patients were followed for a mean of 5.3 years. The outcomes were compared between the 235 women and 167 men.

The results showed that of the 402 patients, 71 percent were found to have adenomatous polyps and 2.2 percent were diagnosed with colon cancer (seven women and two men). The odds ratio for diagnosis of colon cancer was 23.35 in patients with mesenteric or retroperitoneal lymph nodes, 4.67 for abscess, and 24.43 in patients with obstruction and localized mass reported on CT.

There was a significant correlation between the location of diverticulitis and cancer. The diagnosis of cancer was made within six months from the date of CECT in eight patients. The odds of cancer were 2.5 times higher in women.

The authors concluded with the recommendation of "early colonoscopy in patients with wall thickness more than 6 mm, abscess, obstruction, or lymph nodes seen on CECT."