Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Mar 16, 2021; 13(3): 82-89
Published online Mar 16, 2021. doi: 10.4253/wjge.v13.i3.82
Post-colonoscopy diverticulitis: A systematic review
Zi Qin Ng, Jih Huei Tan, Henry Chor Lip Tan, Mary Theophilus
Zi Qin Ng, Mary Theophilus, Department of General Surgery, St John of God Midland Hospital, Midland 6056, Western Australia, Australia
Jih Huei Tan, Henry Chor Lip Tan, Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru 80100, Johor, Malaysia
Mary Theophilus, Curtin Medical School, Curtin University, Bentley 6102, Western Australia, Australia
Author contributions: Ng ZQ contributed study design, collected and analyzed data, drafted manuscript; Tan JH and Tan HCL collected and analyzed data and reviewed manuscript; Theophilus M contributed co-designed study, analyzed data and critical review of manuscript; all authors approved final version of manuscript to be published.
Conflict-of-interest statement: The authors declare no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zi Qin Ng, MBBS (Hons), General Surgery Trainee, Department of General Surgery, St John of God Midland Hospital, 1 Clayton Street, Midland 6056, Western Australia, Australia. kentng@hotmail.co.uk
Received: December 3, 2020
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
ARTICLE HIGHLIGHTS
Research background

The number of colonoscopy performed worldwide is increasing steadily over the past decade for screening, diagnostics and surveillance purposes. Similarly, the incidence of diverticular disease is also increasing in the population.

Research motivation

The entity of post-colonoscopy diverticulitis as a complication of colonoscopy has been reported in the literature without clear description of definition, description, clinical presentation and management strategies.

Research objectives

The aim of this study was to systematically review all available evidence in the literature to propose a definition of post-colonoscopy diverticulitis, describe its incidence, clinical presentation, risk factors and management strategies.

Research methods

The systematic review was performed by searching the PubMed, EMBASE and Cochrane databases up to June 2020 and the references were manually cross-checked for additional references.

Research results

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. Diagnosis was made mainly by computed tomography scan. Most of the patients were managed non-operatively with bowel rest and intravenous antibiotics.

Research conclusions

The entity of post-colonoscopy diverticulitis remains debatable due to the variable timeframe included following colonoscopy in the literature. Regardless of whether this is a true complication post-colonoscopy or a de novo event, early diagnosis is vital to guide appropriate treatment.

Research perspectives

The results of this systematic review should inform future prospective studies especially registries to record this as a potential complication following colonoscopy to further understand its true incidence and risk factors.