Brief Article
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World J Gastroenterol. Dec 14, 2013; 19(46): 8709-8713
Published online Dec 14, 2013. doi: 10.3748/wjg.v19.i46.8709
Pattern and distribution of colonic diverticulosis: Analysis of 2877 barium enemas in Thailand
Varut Lohsiriwat, Wanwarang Suthikeeree
Varut Lohsiriwat, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Wanwarang Suthikeeree, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Author contributions: Lohsiriwat V contributed to the literature review, research design, analysis of data, and manuscript preparation; Suthikeeree W contributed to acquisition of data and critically reviewed the manuscript.
Supported by Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Correspondence to: Varut Lohsiriwat, MD, PhD, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Prannok Road, Bangkok 10700, Thailand. bolloon@hotmail.com
Telephone: +66-2-4198005 Fax: +66-2-4121370
Received: July 1, 2013
Revised: September 30, 2013
Accepted: October 19, 2013
Published online: December 14, 2013
Processing time: 170 Days and 8.3 Hours
Abstract

AIM: To determine the pattern and distribution of colonic diverticulosis in Thai adults.

METHODS: A review of the computerized radiology database for double contrast barium enema (DCBE) in Thai adults was performed at the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. Incomplete studies and DCBE examinations performed in non-Thai individuals were excluded. The pattern and distribution of colonic diverticulosis detected during DCBE studies from June 2009 to October 2011 were determined. The occurrence of solitary cecal diverticulum, rectal diverticulum and giant diverticulum were reported. Factors influencing the presence of colonic diverticulosis were evaluated.

RESULTS: A total of 2877 suitable DCBE examinations were retrospectively reviewed. The mean age of patients was 59.8 ± 14.7 years. Of these patients, 1778 (61.8%) were female and 700 (24.3%) were asymptomatic. Colonic diverticulosis was identified in 820 patients (28.5%). Right-sided diverticulosis (641 cases; 22.3%) was more frequently reported than left-sided diverticulosis (383 cases; 13.3%). Pancolonic diverticulosis was found in 98 cases (3.4%). The occurrence of solitary cecal diverticulum, rectal diverticulum and giant diverticulum were 1.5% (42 cases), 0.4% (12 cases), and 0.03% (1 case), respectively. There was no significant difference in the overall occurrence of colonic diverticulosis between male and female patients (28.3% vs 28.6%, P = 0.85). DCBE examinations performed in patients with some gastrointestinal symptoms revealed the frequent occurrence of colonic diverticulosis compared with those performed in asymptomatic individuals (29.5% vs 25.3%, P = 0.03). Change in bowel habit was strongly associated with the presence of diverticulosis (a relative risk of 1.39; P = 0.005). The presence of diverticulosis was not correlated with age in symptomatic patients or asymptomatic individuals (P > 0.05).

CONCLUSION: Colonic diverticulosis was identified in 28.5% of DCBE examinations in Thai adults. There was no association between the presence of diverticulosis and gender or age.

Keywords: Colonic diverticulosis, Diverticular disease, Barium enema, Pattern, Thailand, Cecal diverticulum, Rectal diverticulum, Giant diverticulum

Core tip: Based on this study in the largest university hospital in Thailand, colonic diverticulosis was identified in 28.5% of double contrast barium enemas performed in Thai adults. The incidence of colonic diverticulosis in the present study was markedly higher than that previously reported from hospital-based data of colonic diverticulosis in Thailand in 1980. This study also demonstrated that there was no significant association between the presence of diverticulosis and gender or age. However, colonic diverticulosis was more commonly reported in patients with some gastrointestinal symptoms, especially those with a change in bowel habit.