Evidence map›Paper›PMID 36932189›Full record

Observational studySurgical endoscopy2023

Can endoscopic follow-up after acute diverticulitis be rationalised?

Harry Frederick Dean, Emily Britton, Emily Farrow, Sameerah Abdel-Khaleq, Natasha Lakin, Molly Bradbury, Tim Cook

Open access · bronzeAbstract readObservational Study
In one paragraph

Observational study in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.2field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. Follow-Up Colonoscopy for Detection of Missed Colorectal Cancer After Diverticulitis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024
    Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Harry Frederick DeanDepartment of Colorectal Surgery, Gloucestershire Hospitals NHS Foundation Trust, Great Western Rd, Gloucester, GL1 3NN, UK. harry.dean1@nhs.net.ORCID 0000-0003-0842-8987
Emily BrittonDepartment of Colorectal Surgery, Gloucestershire Hospitals NHS Foundation Trust, Great Western Rd, Gloucester, GL1 3NN, UK.
Emily FarrowDepartment of Colorectal Surgery, Gloucestershire Hospitals NHS Foundation Trust, Great Western Rd, Gloucester, GL1 3NN, UK.
Sameerah Abdel-KhaleqDepartment of Colorectal Surgery, Gloucestershire Hospitals NHS Foundation Trust, Great Western Rd, Gloucester, GL1 3NN, UK.
Natasha LakinDepartment of Colorectal Surgery, Gloucestershire Hospitals NHS Foundation Trust, Great Western Rd, Gloucester, GL1 3NN, UK.
Molly BradburyDepartment of Colorectal Surgery, Gloucestershire Hospitals NHS Foundation Trust, Great Western Rd, Gloucester, GL1 3NN, UK.
Tim CookDepartment of Colorectal Surgery, Gloucestershire Hospitals NHS Foundation Trust, Great Western Rd, Gloucester, GL1 3NN, UK.
Gloucestershire Hospitals NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute diverticulitis (AD) is a common cause of presentation to emergency surgical services. Follow-up with endoluminal investigation to exclude colorectal cancer (CRC) remains controversial. Guidelines are increasingly moving to a more restrictive follow-up based on severity of disease and age. The purpose of this observational study was to assess the prevalence of CRC in AD patients and the impact of follow-up on endoscopy services.

methodsPatients admitted with a diagnosis of AD over a 2-year period were reviewed. The proportion of patients undergoing endoscopic follow-up and the CRC detection rate were recorded. The potential impact of a more conservative approach to follow-up was evaluated.

resultsThere were 484 patients with AD presenting 546 times (M:F = 198:286; median age = 63 years). 80% of admissions were aged 50 or older. There were 43 emergency interventions in 39 patients (10 percutaneous drain; 33 surgery). The remainder were managed conservatively. 28 patients (5.1%) underwent colonic resection with cancer found in one specimen (3.6%). 287 patients underwent endoluminal follow-up with cancer diagnosed in 3 cases (1.0%). There was no significant difference in the prevalence of CRC between patients requiring emergency surgery and those managed conservatively, or between patients with complicated versus uncomplicated diverticulitis.

conclusionCRC masquerading as acute diverticulitis is rare. The incidence of neoplasia both at endoscopic follow-up and in patients requiring emergency intervention is low. Conservative follow-up strategies appear safe, but their effectiveness in reducing the burden on endoscopy services may be limited by current age-based recommendations. Restricting follow-up to those with complicated AD would reduce the number of patients requiring endoluminal investigation by 70%.

Indexed as

Colorectal NeoplasmsDiverticulitisDiverticulitis, ColonicAcute DiseaseColonoscopyFollow-Up StudiesHumansMiddle AgedRetrospective StudiesColorectal cancerDivericulitisEndoscopy

Identifiers

PMID36932189
PMCPMC10023004
OpenAlexW4327712618

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.