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학술저널
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Shafquat Zaman (Sandwell & West Birmingham Hospitals NHS Trust Sandwell General Hospital West Bromwich) Warren Chapman (Sandwell & West Birmingham Hospitals NHS Trust Birmingham City Hospital Birmingham) Imtiyaz Mohammed (Sandwell & West Birmingham Hospitals NHS Trust Sandwell General Hospital West Bromwich) Kathryn Gill (Sandwell & West Birmingham Hospitals NHS Trust Sandwell General Hospital West Bromwich) Stephen Thomas Ward (University Hospitals Coventry & Warwickshire NHS Trust Walsgrave UK)
저널정보
대한장연구학회 Intestinal research Intestinal research Vol.15 No.2
발행연도
2017.1
수록면
195 - 202 (8page)

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Background/Aims: Traditionally, patients with acute diverticulitis undergo follow-up endoscopy to exclude colorectal cancer(CRC). However, its usefulness has been debated in this era of high-resolution computed tomography (CT) diagnosis. We assessedthe frequency and outcome of endoscopic follow-up for patients with CT-proven acute diverticulitis, according to theconfidence in the CT diagnosis. Methods: Records of patients with CT-proven acute diverticulitis between October 2007 andMarch 2014 at Sandwell & West Birmingham Hospitals NHS Trust were retrieved. The National Cancer Registry confirmedthe cases of CRC. Endoscopy quality indicators were compared between these patients and other patients undergoing thesame endoscopic examination over the same period. Results: We identified 235 patients with CT-proven acute diverticulitis,of which, 187 were managed conservatively. The CT report was confident of the diagnosis of acute diverticulitis in 75% cases. Five of the 235 patients were subsequently diagnosed with CRC (2.1%). Three cases of CRC were detected in the 187 patientsmanaged conservatively (1.6%). Forty-eight percent of the conservatively managed patients underwent follow-up endoscopy;one case of CRC was identified. Endoscopies were often incomplete and caused more discomfort for patients with diverticulitiscompared with controls. Conclusions: CRC was diagnosed in patients with CT-proven diverticulitis at a higher rate than inscreened asymptomatic populations, necessitating follow-up. CT reports contained statements regarding diagnostic uncertaintyin 25% cases, associated with an increased risk of CRC. Follow-up endoscopy in patients with CT-proven diverticulitis isassociated with increased discomfort and high rates of incompletion. The use of other follow-up modalities should be considered.

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