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. 2021 Mar 16;13(3):82-89.
doi: 10.4253/wjge.v13.i3.82.

Post-colonoscopy diverticulitis: A systematic review

Zi Qin Ng  1 , Jih Huei Tan  2 , Henry Chor Lip Tan  2 , Mary Theophilus  3
Affiliations

Post-colonoscopy diverticulitis: A systematic review

Zi Qin Ng et al. World J Gastrointest Endosc. .

Abstract

Background: Post-colonoscopy diverticulitis is increasingly recognized as a potential complication. However, the evidence is sparse in the literature.

Aim: To systematically review all available evidence to describe the incidence, clinical course with management and propose a definition.

Methods: The databases PubMed, EMBASE and Cochrane databases were searched using with the keywords up to June 2020. Additional manual search was performed and cross-checked for additional references. Data collected included demographics, reason for colonoscopy, time to diagnosis, method of diagnosis (clinical vs imaging) and management outcomes.

Results: A total of nine studies were included in the final systematic review with a total of 339 cases. The time to diagnosis post-colonoscopy ranged from 2 h to 30 d. Clinical presentation for these patients were non-specific including abdominal pain, nausea/vomiting, per rectal bleeding and chills/fever. Majority of the cases were diagnosed based on computed tomography scan. The management for these patients were similar to the usual patients presenting with diverticulitis where most resolve with non-operative intervention (i.e., antibiotics and bowel rest).

Conclusion: The entity of post-colonoscopy diverticulitis remains contentious where there is a wide duration post-procedure included. Regardless of whether this is a true complication post-colonoscopy or a de novo event, early diagnosis is vital to guide appropriate treatment. Further prospective studies especially registries should include this as a complication to try to capture the true incidence.

Keywords: Antibiotics; Colonoscopy; Complication; Diverticulitis; Management; Surgery.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart of the search pathway for post-colonoscopy diverticulitis.
See this image and copyright information in PMC

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