Brief Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 21, 2013; 19(15): 2362-2367
Published online Apr 21, 2013. doi: 10.3748/wjg.v19.i15.2362
Colonoscopy can miss diverticula of the left colon identified by barium enema
Ryota Niikura, Naoyoshi Nagata, Takuro Shimbo, Junichi Akiyama, Naomi Uemura
Ryota Niikura, Naoyoshi Nagata, Takuro Shimbo, Junichi Akiyama, Naomi Uemura, Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Shinjuku, Tokyo 162-8655, Japan
Takuro Shimbo, Department of Clinical Research and Informatics, National Center for Global Health and Medicine, Shinjuku, Tokyo 162-8655, Japan
Naomi Uemura, Department of Gastroenterology and Hepatology, Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa, Chiba 272-8516, Japan
Author contributions: Niikura R collected the clinical information and was the main author of the manuscript; Shimbo T performed the statistical analysis; Nagata N and Akiyama J edited the manuscript; Nagata N and Uemura N designed the study.
Supported by A grant from the National Center for Global Health and Medicine
Correspondence to: Dr. Naoyoshi Nagata, Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo 162-8655, Japan. nnagata_ncgm@yahoo.co.jp
Telephone: +81-3-32027181 Fax: +81-3-32071038
Received: November 1, 2012
Revised: February 27, 2013
Accepted: March 6, 2013
Published online: April 21, 2013
Processing time: 169 Days and 0.1 Hours
Abstract

AIM: To identify the diagnostic value of colonoscopy for diverticulosis as determined by barium enema.

METHODS: A total of 65 patients with hematochezia who underwent colonoscopy and barium enema were analyzed, and the diagnostic value of colonoscopy for diverticula was assessed. The receiver operating characteristic area under the curve was compared in relation to age (< 70 or ≥ 70 years), sex, and colon location. The number of diverticula was counted, and the detection ratio was calculated.

RESULTS: Colonic diverticula were observed in 46 patients with barium enema. Colonoscopy had a sensitivity of 91% and specificity of 90%. No significant differences were found in the receiver operating characteristic area under the curve (ROC-AUC) for age group or sex. The ROC-AUC of the left colon was significantly lower than that of the right colon (0.81 vs 0.96, P = 0.02). Colonoscopy identified 486 colonic diverticula, while barium enema identified 1186. The detection ratio for the entire colon was therefore 0.41 (486/1186). The detection ratio in the left colon (0.32, 189/588) was significantly lower than that of the right colon (0.50, 297/598) (P < 0.01).

CONCLUSION: Compared with barium enema, only half the number of colonic diverticula can be detected by colonoscopy in the entire colon and even less in the left colon.

Keywords: Colonoscopic diagnosis; Colonic diverticulosis; Colonic diverticular bleeding; Barium enema; Receiver operating characteristic area under the curve

Core tip: We identified the diagnostic value of colonoscopy for colonic diverticulosis as determined by barium enema. The only half the number of colonic diverticula can be detected in the entire colon and even less in the left colon. By revealing the diagnostic value of colonoscopy for colonic diverticula, it may contribute to further therapeutic interventions strategies for the treatment of colonic diverticular disease.