Document Detail


Early colonoscopy in patients with acute diverticulitis: results of a prospective pilot study.
MedLine Citation:
PMID:  15202046     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND STUDY AIMS: Outcomes following early colonoscopy in patients with acute diverticulitis have not previously been studied. The present study describes the effects of early colonoscopy in patients with acute diverticulitis. PATIENTS AND METHODS: Consecutive patients hospitalized for acute diverticulitis were included in the study. In the first phase, patients with adjacent peridiverticular air or fluid on computed tomography (CT) were excluded. In the second phase of the study, only patients with free intraperitoneal air were excluded. RESULTS: The study population consisted of 107 patients. During the first phase of the study, 49 patients were included; 10 were excluded because of peridiverticular air or fluid. The remaining 39 patients underwent uneventful colonoscopy. During the second phase of the study, 58 patients were included; four were excluded because of free air in the peritoneum. The remaining 54 patients underwent colonoscopy, and perforation of the sigmoid colon occurred in one patient with peridiverticular air. Complete colonoscopy to the cecum or to the obstructing tumor was achieved in 76 patients (81.7 %). A second colonoscopy performed 6 weeks later in 16 of the remaining 17 patients was successfully completed. Findings during the first colonoscopy were polyps in nine cases, polyp with infiltrating adenocarcinoma in one, obstructing adenocarcinoma in one, and a bone trapped in a diverticulum in another one. The latter two patients had a more protracted course and were clearly the ones who benefited most from the colonoscopy. CONCLUSIONS: Early colonoscopy in patients with acute diverticulitis may alter the working diagnosis and be of therapeutic value. The rate of cecal intubation is lower and the perforation rate appears to be higher. A clear-cut indication therefore has to be evident clinically.
Authors:
E Sakhnini; A Lahat; E Melzer; S Apter; C Simon; M Natour; E Bardan; S Bar-Meir
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Endoscopy     Volume:  36     ISSN:  0013-726X     ISO Abbreviation:  Endoscopy     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-17     Completed Date:  2004-09-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0215166     Medline TA:  Endoscopy     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  504-7     Citation Subset:  IM    
Affiliation:
Dept. of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer and Sackler School of Medicine, Tel Aviv University, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / diagnosis
Adult
Aged
Aged, 80 and over
Air
Cecum / pathology
Colon, Sigmoid / injuries
Colonic Neoplasms / diagnosis
Colonic Polyps / diagnosis
Colonoscopy*
Diverticulitis, Colonic / diagnosis*,  radiography
Exudates and Transudates
Female
Follow-Up Studies
Foreign Bodies / diagnosis
Humans
Intestinal Obstruction / diagnosis
Male
Middle Aged
Peritoneal Cavity
Pilot Projects
Prospective Studies
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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