Utility of Colonoscopy to Exclude Underlying Malignant Polyps After Resolution of Uncomplicated Diverticulitis.

intervention, or monitoring.3 After resolution of an episode of diverticulitis, the standard of care is to perform a colonoscopy to exclude diagnoses that mimic diverticulitis—notably, colorectal cancer. This recommendation arose during a time when the diagnosis rested on clinical suspicion and radio­ graphic imaging with barium.4 Computed tomog­ raphy, with a substantially higher sensitivity than barium enema5 at diagnosing cancer and other ab­ dominal pathologic conditions, is now the primary modality used to define complicated diverticulitis, with low interobserver variability and a sensitivity and specificity approaching 99%.6 Computed tomo­ graphic findings in complicated diverticulitis in­ clude abscess, fistula, stricture, extensive stranding, obstruction, or air (ie, perforation); colonic wall thickening and mass lesions are concerning radio­ logic features for neoplasia. The current Clinical Guideline Task Force of the American Society of Colon and Rectal Surgeons recommends that “after resolution of acute diverticu­ litis, perform colonoscopy in 6 to 8 weeks following resolution, to confirm diagnosis; if this is first epi­ sode or recent colonoscopy has not been done” Utility of Colonoscopy to Exclude Underlying Malignant Polyps After Resolution of Uncomplicated Diverticulitis