摘要
BACKGROUND Post-colonoscopy diverticulitis is increasingly recognized as a potential complication.However,the evidence is sparse in the literature.AIM To systematically review all available evidence to describe the incidence,clinical course with management and propose a definition.METHODS 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.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 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).CONCLUSION 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.
