Mohab Elsalahi
Introduction
This retrospective audit evaluated compliance with follow-up colonoscopy guidelines in patients with acute diverticulitis, specifically adherence to the recommended 6-8 week follow-up for complicated cases. Current guidelines from the World Society of Emergency Surgery and European Society of Coloproctology advise colonoscopy 6-8 weeks after resolution of complicated diverticulitis to rule out malignancy. Colonoscopy is not routinely recommended for uncomplicated cases unless malignancy is suspected.
Method
The audit was conducted in two cycles. The first cycle (September 2023–March 2024) included 51 patients: 23 with complicated and 28 with uncomplicated diverticulitis. The second cycle (September 2024–March 2025) included 46 patients: 24 complicated and 22 uncomplicated cases. Colonoscopy rates, timing, and findings were recorded and compared. Malignancy rates and the need for emergency surgery were also assessed.
Results
In the first cycle, only 1 of 21 colonoscopies was performed within the 6-8 week period, and 1 malignancy was detected. After staff training and awareness initiatives, 6 of 18 complicated cases in the second cycle received timely colonoscopy, representing a significant improvement. No malignancies were detected in the second cycle. Overall, 46% of complicated cases had timely colonoscopy, compared to 5% in the first cycle.
Conclusions
The audit shows significant improvement in colonoscopy compliance for complicated diverticulitis. Given the low malignancy risk, routine colonoscopy for uncomplicated cases should be reconsidered. Future recommendations include enhancing discharge procedures and prioritizing colonoscopy for complicated cases.
Authors
Mohab Elsalahi, Mohammad Saduddin Sajol, Shagufta Jabeen, Mohamed Omar Elsllabi, Asad Toor
NHS Lanarkshire, Glasgow, United Kingdom