Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 May 10;11(5):e01362.
doi: 10.14309/crj.0000000000001362. eCollection 2024 May.

Postcolonoscopy Diverticulitis

Mahmoud E Essam  1   2 , Iosif Beintaris  1 , Matthew D Rutter  1
Affiliations
Case Reports

Postcolonoscopy Diverticulitis

Mahmoud E Essam et al. ACG Case Rep J. .

Abstract

Colonoscopy, generally safe but not devoid of risks, can lead to rare complications. We present 2 cases of postcolonoscopy diverticulitis (PCD). Case 1 was a 63-year-old woman, following colonoscopy, who developed acute sigmoid diverticulitis, despite a Diverticular Inflammation and Complication Assessment (DICA) score of 2, indicating extensive diverticulosis without inflammation. Conservative management with antibiotics led to recovery. Remarkably, she experienced a recurrent episode. Case 2 was a 74-year-old woman who had 2 colonoscopies, revealing pancolonic diverticulosis (DICA score: 2) without inflammation. After the second procedure, she developed severe sigmoid diverticulitis, managed conservatively with antibiotics. Discussion highlights PCD's rarity (prevalence: 0.04%-0.08%) and unclear pathogenesis. Both cases had DICA scores ≥2, suggesting a potential risk factor. Clinicians should recognize PCD, as it can mimic more common postcolonoscopy complications. Early recognition and management are vital.

Keywords: DICA score; colonoscopy; complication; conservative management; diverticulitis.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Colonoscopy showing sigmoid diverticula (A) and small polyps (B).
Figure 2.
Figure 2.
Scattered diverticula in the cecum (A) and a 40 mm sessile transverse colon polyp (B).
Figure 3.
Figure 3.
Case 2: Endoscopic mucosal resection defect after snare-tip soft coagulation and clipping.
Figure 4.
Figure 4.
Case 2: Computed tomography 5 days after colonoscopy, following the patient presenting with symptoms of acute diverticulitis. Features of mural thickening and pericolic fat stranding (arrows).
See this image and copyright information in PMC

References

    1. Rutter CM, Johnson E, Miglioretti DL, Mandelson MT, Inadomi J, Buist DSM. Adverse events after screening and follow-up colonoscopy. Cancer Causes Control. 2012;23(2):289–96. - PMC - PubMed
    1. Ko CW, Riffle S, Michaels L, et al. . Serious complications within 30 days of screening and surveillance colonoscopy are uncommon. Clin Gastroenterol Hepatol. 2010;8(2):166–73. - PMC - PubMed
    1. Bhatia M, Mattoo A. Diverticulosis and diverticulitis: Epidemiology, pathophysiology, and current treatment trends. Cureus. 2023;15(8):e43158. - PMC - PubMed
    1. Tursi A, Brandimarte G, Di Mario F, et al. . Development and validation of an endoscopic classification of diverticular disease of the colon: The DICA classification. Dig Dis. 2015;33(1):68–76. - PubMed
    1. Ng ZQ, Tan JH, Tan HCL, Theophilus M. Post-colonoscopy diverticulitis: A systematic review. World J Gastrointest Endosc. 2021;13(3):82–9. - PMC - PubMed

Publication types