Published online Mar 16, 2021. doi: 10.4253/wjge.v13.i3.82
Peer-review started: December 3, 2020
First decision: December 31, 2020
Revised: December 31, 2020
Accepted: February 12, 2021
Article in press: February 12, 2021
Published online: March 16, 2021
Processing time: 95 Days and 21 Hours
Post-colonoscopy diverticulitis is increasingly recognized as a potential complication. However, the evidence is sparse in the literature.
To systematically review all available evidence to describe the incidence, clinical course with management and propose a definition.
The databases PubMed, EMBASE and Cochrane databases were searched using with the keywords up to June 2020. Additional manual search was performed and cross-checked for additional references. Data collected included demographics, reason for colonoscopy, time to diagnosis, method of diagnosis (clinical vs imaging) and management outcomes.
A total of nine studies were included in the final systematic review with a total of 339 cases. The time to diagnosis post-colonoscopy ranged from 2 h to 30 d. Clinical presentation for these patients were non-specific including abdominal pain, nausea/vomiting, per rectal bleeding and chills/fever. Majority of the cases were diagnosed based on computed tomography scan. The management for these patients were similar to the usual patients presenting with diverticulitis where most resolve with non-operative intervention (i.e., antibiotics and bowel rest).
The entity of post-colonoscopy diverticulitis remains contentious where there is a wide duration post-procedure included. Regardless of whether this is a true complication post-colonoscopy or a de novo event, early diagnosis is vital to guide appropriate treatment. Further prospective studies especially registries should include this as a complication to try to capture the true incidence.
Core Tip: The entity of post-colonoscopy diverticulitis is a rare complication. However, there is no consensus on its definition especially on the duration included post-procedure. It could well represent a de novo event or exacerbation of subacute condition. Regardless, it should be considered as a differential in patients presenting with abdominal pain post-colonoscopy and managed according to the usual treatment of patients presenting with diverticulitis.