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Medicine (Baltimore) 2021 May;100(21):e26085

Department of General and Gastroenterological Surgery.

Rationale: As the world's population ages, the number of surgical cases of colovesical fistulas secondary to colon diverticulitis is also expected to increase. The key issue while performing laparoscopic surgery for these fistulas is the avoidance of iatrogenic ureteral injury. There are no reports of Near-infrared Ray Catheter being used in surgery for diverticulitis, which is one of the diseases with the highest risk of ureteral injury. Read More

Clin Imaging 2021 Apr 29;79:133-135. Epub 2021 Apr 29.

2160 S 1st Ave, Maywood, IL 60153, Department of Radiology c/o Linda Schomer, United States of America. Electronic address:

Colonoscopy is the most sensitive and specific test for detecting colon cancer and is a common procedure performed in over 19 million people annually in the United States as of 2017. Though the incidence of complications from colonoscopy is low, there are several important complications that may require surgical intervention including bowel perforation, bleeding, splenic injury, and diverticulitis. Post-polypectomy coagulation syndrome (PPCS) is an uncommon complication of colonoscopy however, clinical presentation mimics bowel perforation and the differentiation between the two is vital as the management differs. Read More

Chirurg 2021 Apr 14. Epub 2021 Apr 14.

Medizinische Fakultät, Universität Köln, Köln, Deutschland.

Diverticula of the colon are very common and usually asymptomatic but 20% of people with diverticulosis develop symptoms and sometimes also complications, such as diverticulitis with abscesses or perforation and bleeding. In the long-term stenoses or a conglomerate can occur. The treatment depends on the type of diverticular disease, on the knowledge of risk indicators and imaging with sonography or computed tomography (CT). Read More

BMJ 2021 03 24;372:n72. Epub 2021 Mar 24.

University of North Carolina School of Medicine, Chapel Hill, NC 27599-7555, USA

Left sided colonic diverticulitis is a common and costly gastrointestinal disease in Western countries, characterized by acute onset of often severe abdominal pain. Imaging is necessary to make an initial diagnosis and determine disease severity. Colonoscopy should be done six to eight weeks after diagnosis to rule out a missed colon malignancy. Read More

World J Gastroenterol 2021 Mar;27(9):760-781

Division of Colorectal Surgery, Department of Surgery, City of Hope National Medical Center, Duarte, CA 91010-3000, United States.

Diverticular disease and diverticulitis are the most common non-cancerous pathology of the colon. It has traditionally been considered a disease of the elderly and associated with cultural and dietary habits. There has been a growing evolution in our understanding and the treatment guidelines for this disease. Read More

BMC Gastroenterol 2021 Feb 27;21(1):91. Epub 2021 Feb 27.

Division of Coloproctology, Department of Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 271, Cheonbo-ro, Uijeongbu, Gyeonggi-do, 11765, Korea.

Background: Routine colonoscopy is recommended to determine the coexistence of colon cancer after medical treatment for colon diverticulitis. However, in the case of uncomplicated diverticulitis diagnosed by computed tomography, the clinical relevance of routine follow-up colonoscopy has recently been debated. Yet, the role of follow-up colonoscopy for right colon diverticulitis, which tends to develop at a younger age than left colon diverticulitis, has not been specifically evaluated. Read More

Radiologia (Engl Ed) 2021 Feb 18. Epub 2021 Feb 18.

Servicio de Cirugía General y Aparato Digestivo, Hospital General de Granollers, Granollers, Barcelona, España; Universitat Internacional de Catalunya, Barcelona, España.

Background And Aims: The current management of acute diverticulitis of the left colon (ADLC) requires tests with high prognostic value. This paper analyzes the usefulness of ultrasonography (US) in the initial diagnosis of ADLC and the validity of current classifications schemes for ADLC.

Patients: This retrospective observational study included patients with ADLC scheduled to undergo US or computed tomography (CT) following a clinical algorithm. Read More

J Med Radiat Sci 2021 Feb 19. Epub 2021 Feb 19.

Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Imaging Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.

Diverticular disease is one of the most common causes of outpatient visits and hospitalisations across Australia, North America and Europe. According to the Gastroenterological Society of Australia (GESA, 2010), approximately 33% of Australians over 45 years of age and 66% over 85 years of age have some form of colonic diverticulosis. Patients with colonic diverticulosis are known to develop subsequent complications such as acute colonic diverticulitis (ACD), and when more than one attack of diverticulitis occurs, there is a 70-90% chance that the individual will experience ongoing problems and recurring infections throughout their lifetime. Read More

Curr Med Imaging 2021 Jan 19. Epub 2021 Jan 19.

Department of Radiology, School of Medicine, Eskişehir Osmangazi University, Eskişehir. Turkey.

Cases of diverticulosis of the colon continue to increase, especially in Western countries. In these countries, two-thirds of the population older than 70 years of age are considered to experience this disease. Medical and surgical treatment for diverticulosis is begun actually for the complications of diverticulitis and lower gastrointestinal hemorrhage. Read More

Int J Surg Case Rep 2021 Feb 15;79:150-155. Epub 2021 Jan 15.

Manila Doctors Hospital, Kalaw Avenue, Manila, 10000, Philippines. Electronic address:

Introduction And Importance: Colouterine fistulas related to diverticulitis are very rare due to the thickness of the uterine myometrium. Other causes related to colouterine fistula formation particularly malignancy, have to be considered. Diagnosis by imaging or endoscopy may be inconclusive. Read More

Gastroenterology 2021 Feb 3;160(3):906-911.e1. Epub 2020 Dec 3.

University of Washington, Seattle, Washington.

Colonic diverticulitis is a painful gastrointestinal disease that recurs unpredictably and can lead to chronic gastrointestinal symptoms. Gastroenterologists commonly care for patients with this disease. The purpose of this Clinical Practice Update is to provide practical and evidence-based advice for management of diverticulitis. Read More

Diagn Interv Radiol 2020 Nov;26(6):546-551

Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia,Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Radiologia Diagnostica e Interventistica Generale, Roma, Italia.

Acute colonic diverticulitis (ACD) is an acute episode of severe and prolonged lower abdominal pain due to diverticular inflammation, usually associated with change in bowel movements, fever, and leukocytosis. Worldwide, computed tomography (CT) of the abdomen and pelvis with intravenous contrast is accepted as the best imaging method for evaluating the diverticular inflammation, serving the following functions: confirming the presence of ACD; evaluation of the disease severity and degree; therapy planning guide in presence of complications (such as abscess or intestinal perforation); diagnosis of other diseases that may simulate diverticular inflammation. In the literature, we found values of CT sensitivity for diverticular inflammation from 79% to 99%; CT is useful in differentiating other diseases, which may cause abdominal pain, when diverticular inflammation is not the cause, such as neoplasm, inflammatory bowel disease, appendix inflammations, epiploic appendix inflammation and colon ischemia. Read More

Cureus 2020 Sep 29;12(9):e10715. Epub 2020 Sep 29.

Department of Radiology: Abdominal Imaging, University of Washington, Seattle, USA.

Acute epiploic appendagitis is a benign condition caused by inflammation of the epiploic appendages that are serosal lined outpouchings of the colon lying adjacent to the tenia coli. This rare condition has non-specific clinical findings and is frequently misdiagnosed as either acute diverticulitis or acute appendicitis. However, unlike other surgical causes of acute abdomen, epiploic appendagitis is a self-limited condition and resolves with conservative management. Read More

Cureus 2020 Sep 28;12(9):e10689. Epub 2020 Sep 28.

Vascular Surgery, Basildon and Thurrock University Hospital, Basildon, GBR.

Epiploic appendagitis (EA) is a rare clinical entity caused by an inflammatory/ischemic process involving the serosal outpouchings of the colon. Its clinical presentation of acute, localised, lower abdominal pain often mimics more common conditions like diverticulitis or appendicitis. The diagnosis of EA is challenging due to the lack of pathognomic clinical features. Read More

Curr Probl Surg 2020 10 18;57(10):100862. Epub 2020 Jul 18.

Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH.

Dis Colon Rectum 2021 02;64(2):181-189

Division of Gastroenterology and Liver Disease, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio.

Background: The incidence of acute diverticulitis is increasing, and previous studies showed a wide range of prevalence of colorectal cancer after diverticulitis. There is a lack of high-quality evidence to support performing colonoscopy after diverticulitis.

Objective: We aimed to describe the incidence of first-ever diverticulitis and prevalence of first-ever colorectal cancer postdiverticulitis in the United States. Read More

Ann R Coll Surg Engl 2020 Nov 21;102(9):744-747. Epub 2020 Aug 21.

Medway Maritime Hospital, Gillingham, UK.

Introduction: The prevalence of diverticular disease has been increasing in the western world over the last few decades, causing a growing burden on health care systems. This study compared the uses of flexible sigmoidoscopy with colonoscopy as a follow-up investigation for patients diagnosed with acute left-sided diverticulitis and to evaluate the need for using either procedure.

Materials And Methods: A retrospective study of 327 patients diagnosed with acute diverticulitis was carried out. Read More

Am J Case Rep 2020 Jul 28;21:e923457. Epub 2020 Jul 28.

Department of General Surgery, Community Memorial Health System, Ventura, CA, USA.

BACKGROUND Diverticulosis and its complication of diverticulitis is a common condition that can be found in up to 35% of the population. Giant colonic diverticulum is a rare entity with fewer than 200 cases reported in the scientific literature. Development of a giant diverticulum as a sequelae of laparoscopic washout is an unreported event in current literature. Read More

Eur J Radiol 2020 09 8;130:109155. Epub 2020 Jul 8.

CHU MONTPELLIER, 391 avenue du doyen Gaston Giraud, 34000, Montpellier, France. Electronic address:

Large bowel obstruction (LBO) is associated with high morbidity and mortality due to delayed diagnosis and/or treatment. MDCT has become the standard of care to identify the site, severity, and etiology of obstruction. The goal of this review is fourfold. Read More

Case Rep Surg 2020 4;2020:3126495. Epub 2020 Jul 4.

2nd Department of Surgery, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, Greece.

Introduction: Epiploic appendagitis is a rare cause of acute abdominal pain, mimicking acute diverticulitis or appendicitis. Epiploic appendagitis causing small bowel obstruction is highly unusual, and only a handful of such cases have been reported so far. . Read More

ANZ J Surg 2021 03 20;91(3):E123-E125. Epub 2020 Jul 20.

Department of Urology, Gosford Hospital, Central Coast Local Health District, Central Coast Region, New South Wales, Australia.

J Am Board Fam Med 2020 Jul-Aug;33(4):549-560

From the Department of Gastroenterology, Kaiser Permanente-Southern California, San Diego (GFL, CW); Department of Research & Evaluation, Kaiser Permanente-Southern California, Pasadena (QC).

Introduction: Irritable bowel syndrome (IBS) and diverticulitis share clinical features. Misdiagnosed diverticulitis can cause unnecessary antibiotic therapy. Among IBS and non-IBS patients, we compared outpatient, clinically diagnosed (no computed tomography) diverticulitis rates. Read More

Cureus 2020 Apr 30;12(4):e7897. Epub 2020 Apr 30.

General Surgery, Hamad Medical Corporation, Doha, QAT.

Epiploic appendagitis (EA) is a rare and often misdiagnosed cause of acute abdominal pain. It is a benign and self-limited condition but mimics other underlying causes of acute abdominal pain like acute diverticulitis, acute appendicitis, acute cholecystitis, etc. Inaccurate diagnosis can lead to iatrogenic adverse outcomes. Read More

Eur J Radiol 2020 Jul 30;128:109026. Epub 2020 Apr 30.

Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, United States.

Diverticular disease of the colon and small bowel is an important cause of pathology leading to emergency department visits and urgent gastrointestinal surgery. CT is a highly sensitive and specific modality for the diagnosis of acute diverticulitis and its complications as well as for the exclusion of alternate causes of pathology. Ultrasound, MRI and virtual CT colonoscopy have important adjunct roles for screening and workup of complications in specific patient populations. Read More

Dis Colon Rectum 2020 06;63(6):728-747

Section of Colorectal Surgery, Rutgers University, New Brunswick, New Jersey.

Ir Med J 2020 01 16;113(1):12. Epub 2020 Jan 16.

Department of Surgery, Connolly Hospital Blanchardstown, Dublin 15.

Presentation We describe an unusual presentation of sigmoid colon perforation secondary to an ingested chicken bone. Diagnosis The patient presented with a 4 day history of abdominal pain and distension. On examination there were signs of peritonism. Read More

PLoS One 2020 9;15(4):e0229884. Epub 2020 Apr 9.

First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.

Objective: We evaluated the characteristics of patients with diverticular bleeding in whom emergency endoscopy should be proactively performed and those in whom it is unnecessary for spontaneous hemostasis following conservative treatment.

Methods: This study involved 132 patients in whom diverticular bleeding was diagnosed on lower gastrointestinal endoscopy. We evaluated the rate of identification of the bleeding diverticulum during endoscopy and the rate of spontaneous hemostasis following conservative treatment. Read More

Dis Colon Rectum 2020 05;63(5):701-709

Department of Colorectal Surgery, Singapore General Hospital.

Background: CT findings of acute diverticulitis can overlap with features of malignancy, and current guidelines recommend colonic evaluation after acute diverticulitis. However, the benefits of routine colonic evaluation have been questioned.

Objective: We review 30 studies, composed of 29,348 subjects, to evaluate the role of routine colonic evaluation after CT-proven acute diverticulitis. Read More

Nat Rev Dis Primers 2020 03 26;6(1):20. Epub 2020 Mar 26.

IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Center - IRCCS -, Rozzano, Italy.

Diverticula are outpouchings of the intestinal wall and are common anatomical alterations detected in the human colon. Colonic diverticulosis (the presence of diverticula in the colon; referred to as diverticulosis) remains asymptomatic in most individuals but ~25% of individuals will develop symptomatic diverticulosis, termed colonic diverticular disease (also known as diverticular disease). Diverticular disease can range in severity from symptomatic uncomplicated diverticular disease (SUDD) to symptomatic disease with complications such as acute diverticulitis or diverticular haemorrhage. Read More

Jpn J Radiol 2020 Jun 14;38(6):572-578. Epub 2020 Mar 14.

Department of Pathology, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan.

Purpose: Because appendiceal diverticulitis (AD) has a high risk of perforation, precise diagnosis is important for patients with suspected acute appendicitis (AA). In this study, we aimed to reveal the characteristics of computed tomography (CT) images of AD.

Methods: CT images were comparatively analyzed in patients who underwent appendectomy and had histopathologically proved AD (n = 23) or AA (n = 365) to reveal specific findings of CT image for AD and determine sensitivity and specificity of CT for AD. Read More