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
Multicenter Study
. 2025 May;107(5):326-330.
doi: 10.1308/rcsann.2024.0077. Epub 2024 Oct 9.

Analysis of the outcomes of postdiverticulitis investigations: a multicentre cohort study including 1,120 patients

A Abdelrahim  1 , O Ali  2 , D Kamali  3 , A Reddy  4 , S Harrison  3 , M Boshnaq  5   6 , H Abudeeb  2 , F Ashoush  7 , M Qulaghassi  5 , S Eldesouky  5 , M Mansour  4 , S F Rahman-Casans  3 , K Osman  3
Affiliations
Multicenter Study

Analysis of the outcomes of postdiverticulitis investigations: a multicentre cohort study including 1,120 patients

A Abdelrahim et al. Ann R Coll Surg Engl. 2025 May.

Abstract

Introduction: The aim of this study was to assess the yield of the endoscopic investigations performed following the resolution of acute diverticulitis.

Methods: A retrospective multicentre study included patients with multislice computed tomography (MSCT)-proven diverticulitis, in four NHS hospitals, between January 2016 and April 2023. The primary outcome was the rate of colonic cancer in the diseased segment. Secondary outcomes included the rate of malignancy in the nondiseased colonic segments, the benign colonic polyp detection rate, the rate of malignancy in the resected surgical specimens in patients who underwent an emergency surgery on the index admission and the rate of complications in the investigated group.

Results: A total of 1,120 patients were included in the study, out of which 604 were females, with a median age of 61 years; 731 patients (65%) had uncomplicated diverticulitis (Hinchey 1A) while 389 (35%) had complicated diverticulitis (Hinchey 1B-4). Following the acute episode, 757 (74%) patients had subsequent endoscopic evaluation. The incidence of colorectal cancer (CRC) or advanced adenomas (AA) in patients with uncomplicated diverticulitis was 0.14%. In the complicated diverticulitis group, the incidence of CRC/AA in patients with Hinchey 1b and Hinchey 2 was 1.4% and 5.4%, respectively. Out of the 107 patients who underwent emergency colonic resection for suspected perforated diverticulitis, 18 (16.8%) had histological evidence of colonic malignancy.

Conclusions: Endoscopic investigations following uncomplicated diverticulitis have a low yield for sinister colonic pathology. Colonoscopy should be planned following complicated diverticulitis and in patients with uncomplicated diverticulitis with suspicious radiological finding on index imaging or in patients with ongoing clinical manifestations. In patients who undergo emergency surgery, oncological principles should be applied whenever possible.

Keywords: Colonic; Diverticulitis; Hinchey.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Total number of included and excluded patients.CT = computed tomography
Figure 2
Figure 2
Flowchart of the overall management of all patients.abx = antibiotics; AD = acute diverticulitis; CT = computed tomography; EOLCP = end-of-life care pathway; HGD = high-grade dysplasia; IV = intravenous; RIP = died
See this image and copyright information in PMC

References

    1. Weizman AV, Nguyen GC. Diverticular disease: epidemiology and management. Can J Gastroenterol 2011; 25: 385–389. - PMC - PubMed
    1. Stollman N, Raskin JB. Diverticular disease of the colon. Lancet 2004; 363: 631–639. - PubMed
    1. Kim JH, Cheon JH, Park Set al. . Relationship between disease location and age, obesity, and complications in Korean patients with acute diverticulitis: a comparison of clinical patterns with those of Western populations. Hepatogastroenterology 2008; 55: 983–986. - PubMed
    1. Strate LL, Morris AM. Epidemiology, pathophysiology, and treatment of diverticulitis. Gastroenterology 2019; 156: 1282–1298.e1. - PMC - PubMed
    1. Royal College of Surgeons (RCS) Commissioning guide: Colonic diverticular disease. https://www.rcseng.ac.uk/-/media/files/rcs/library-and-publications/non-...

Publication types

MeSH terms