Top

Published in:

01-03-2016 | Gastrointestinal

Prevalence and distribution of colonic diverticula assessed with CT colonography (CTC)

Authors: Carlo Nicola De Cecco, Maria Ciolina, Bruno Annibale, Marco Rengo, Davide Bellini, Giuseppe Muscogiuri, Antonello Maruotti, Luca Saba, Franco Iafrate, Andrea Laghi

Published in: European Radiology | Issue 3/2016

Abstract

Objectives

This study aimed to evaluate the prevalence of colonic diverticula according to age, gender, distribution, disease extension and symptoms with CT colonography (CTC).

Methods

The study population included 1091 consecutive patients who underwent CTC. Patients with diverticula were retrospectively stratified according to age, gender, clinical symptoms and colonic segment involvement. Extension of colonic diverticula was evaluated using a three-point quantitative scale. Using this data, a multivariate regression analysis was applied to investigate the existence of any correlation among variables.

Results

Colonic diverticula were observed in 561 patients (240 men, mean age 68 ± 12 years). Symptomatic uncomplicated diverticular disease (SUDD) was present in 47.4 % of cases. In 25.6 % of patients ≤40 years, at least one diverticulum in the colon was observed. Prevalence of right-sided diverticula in patients >60 years was 14.2 % in caecum and 18.5 % in ascending colon. No significant difference was found between symptomatic and asymptomatic patients regarding diverticula prevalence and extension. No correlation was present between diverticula extension and symptoms.

Conclusion

The incidence of colonic diverticula appears to be greater than expected. Right colon diverticula do not appear to be an uncommon finding, with their prevalence increasing with patient age. SUDD does not seem to be related to diverticula distribution and extension.

Key Points

• Incidence of colonic diverticula appears to be greater than expected.

• Right colon diverticula do not appear to be an uncommon finding.

• SUDD does not seem to be related to diverticula distribution and extension.

Stollman N, Raskin JB (2004) Diverticular disease of the colon. Lancet 363:631–639CrossRefPubMed

Kohler L, Sauerland S, Neugebauer E (1999) Diagnosis and treatment of diverticular disease: results of a consensus development conference. The scientific committee of the european association for endoscopic surgery. Surg Endosc 13:430–436CrossRefPubMed

Petruzziello L, Iacopini F, Bulajic M et al (2006) Review article: uncomplicated diverticular disease of the colon. Aliment Pharmacol Ther 23:1379–1391CrossRefPubMed

Sandler RS, Everhart JE, Donowitz M et al (2002) The burden of selected digestive diseases in the United States. Gastroenterology 122:1500–1511CrossRefPubMed

Pradel JA, Adell JF, Tauorel P et al (1997) Acute colonic diverticulitis: prospective comparative evaluation with CT and US. Radiology 205:503–512CrossRefPubMed

Rao PM, Rhea JT, Novelline RA et al (1998) Helical CT with only colonic contrast medium for diagnosing diverticulitis. Am J Roentgenol 170:1445–1449CrossRef

Laghi A, Rengo M, Graser A, Iafrate F (2013) Current status on performance of CT colonography and clinical indications. Eur J Radiol 82:1192–1200CrossRefPubMed

Spada C, Stoker J, Alarcon O et al (2015) Clinical indications for computed tomographic colonography: european society of gastrointestinal endoscopy (ESGE) and european society of gastrointestinal and abdominal radiology (ESGAR) guideline. Eur Radiol 25:331–345PubMedCentralCrossRefPubMed

Halligan S, Saunders B (2002) Imaging diverticular disease. Best Pract Res Clin Gastroenterol 16:595–610CrossRefPubMed

10.

Drossman DA, Corazziari E, Delvaux M et al (2006) Rome III, 3rd edn, The functional gastrointestinal disorders. Degnon Associates, McLean, pp pp 1–pp 29

11.

Annibale B, Lahner E, Maconi G, Usai P, Marchi S, Bassotti G et al (2012) Clinical features of symptomatic uncomplicated diverticular disease: a multicenter Italian survey. Int J Colorectal Dis 27:1151–1159CrossRefPubMed

12.

Buckley O, Geogheganb T, O’Riordaina DS, Lyburnc ID, Torreggiani WC (2004) Computed tomography in the imaging of colonic diverticulitis. Clinic Radiol 59:977–983CrossRef

13.

Flor N, Rigamonti P, Pisani Ceretti A, Romagnoli S, Balestra F, Sardanelli F et al (2013) Diverticular disease severity score based on CT colonography. Eur Radiol 23:2723–2729CrossRefPubMed

14.

Gollub MJ, Jhaveri S, Schwartz E, Felderman H, Cooper C, Markowitz AJ et al (2005) CT colonography features of sigmoid diverticular disease. Clin Imaging 29:200–206CrossRefPubMed

15.

Ghuman M, Bates N, Moore H (2012) Computed tomographic colonography (CTC): a retrospective analysis of a single site experience and a review of the literature on the status of CTC. N Z Med J 125:60–67PubMed

16.

Golder M, Ster IC, Babu P et al (2011) Demographic determinants of risk, colon distribution and density scores of diverticular disease. World J Gastroenterol 17:1009–1017PubMedCentralPubMed

17.

Blachut K, Paradowski L, Garcarek J (2004) Prevalence and distribution of the colonic diverticulosis. Review of 417 cases from Lower Silesia in Poland. Rom J Gastroenterol 13:281–285PubMed

18.

Manousos ON, Truelove SC, Lumsden K (1967) Transit times of food in patients with diverticulosis or irritable colon syndrome and normal subjects. Br Med J 3:760–762PubMedCentralCrossRefPubMed

19.

Koehler R (1963) The incidence of colonic diverticulosis in Finland and Sweden. Acta Chir Scand 126:148–155PubMed

20.

Roberts P, Abel M, Rosen L et al (1995) Practice parameters for sigmoid diverticulitis. The standards task force american society of colon and rectal surgeons. Dis Colon Rectum 38:125–132CrossRefPubMed

21.

Debray C, Hardouin JP, Besancon F, Raimbault J (1961) Incidence of colic diverticulosis according to age. Statistical study from 500 barium enemas. Sem Hop 37:1743–1745PubMed

22.

Eusebio EB, Eisenberg MM (1973) Natural history of diverticular disease of the colon in young patients. Am J Surg 125:308–311CrossRefPubMed

23.

Ouriel K, Schwartz SI (1983) Diverticular disease in the young patient. Surg Gynecol Obstet 156:1–5PubMed

24.

Simonowitz D, Paloyan D (1977) Diverticular disease of the colon in patients under 40 years of age. Am J Gastroenterol 67:69–72PubMed

25.

Chodak GW, Rangel DM, Passaro E Jr (1981) Colonic diverticulitis in patients under age 40: need for earlier diagnosis. Am J Surg 141:699–702CrossRefPubMed

26.

Faria GR, Almeida AB, Moreira H et al (2011) Acute diverticulitis in younger patients: any rationale for a different approach? World J Gastroenterol 17:207–212PubMedCentralCrossRefPubMed

27.

Markham NI, Li AK (1992) Diverticulitis of the right colon – experience from Hong Kong. Gut 33:547–549PubMedCentralCrossRefPubMed

28.

Hughes LE (1969) Postmortem survey of diverticular disease of the colon. Gut 10:336–351PubMedCentralCrossRefPubMed

29.

Rodky GV, Welch CE (1984) Changing patterns in the surgical treatment of diverticular disease. Ann Surg 200:466–478CrossRef

30.

Jung H-K, Choung RS, Locke GR 3rd, Schleck CD, Zinsmeister AR, Talley NJ (2010) Diarrhea-predominant irritable bowel syndrome is associated with diverticular disease: a population-based study. Am J Gastroenterol 105:652–661PubMedCentralCrossRefPubMed

31.

Parra-Blanco A (2010) Colonic diverticular disease: pathophysiology and clinical picture. Digestion 73(Suppl 1):47–57

32.

Lee KM, Paik CN, Chung WC et al (2010) Clinical significance of colonic diverticulosis associated with bowel symptoms and colon polyp. J Korean Med Sci 25:1323–1329PubMedCentralCrossRefPubMed

33.

Salemi TA, Molloy RG, O’Dwyer PJ (2007) Prospective, five-year follow-up study of patients with symptomatic uncomplicated diverticular disease. Dis Colon Rectum 50:1460–1464CrossRef

Title: Prevalence and distribution of colonic diverticula assessed with CT colonography (CTC)
Authors: Carlo Nicola De Cecco
Maria Ciolina
Bruno Annibale
Marco Rengo
Davide Bellini
Giuseppe Muscogiuri
Antonello Maruotti
Luca Saba
Franco Iafrate
Andrea Laghi
Publication date: 01-03-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 3/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3866-1

At a glance: The STEP trials

Springer Medicine

Prevalence and distribution of colonic diverticula assessed with CT colonography (CTC)

Abstract

Objectives

Methods

Results

Conclusion

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

Please log in to get access to this content

Other articles of this Issue 3/2016

Differentiation of malignant from benign soft tissue tumours: use of additive qualitative and quantitative diffusion-weighted MR imaging to standard MR imaging at 3.0 T

Polymer film-nanoparticle composites as new multimodality, non-migrating breast biopsy markers

Dynamic multidetector CT and non-contrast-enhanced MR for right adrenal vein imaging: comparison with catheter venography in adrenal venous sampling

In vitro artefact assessment of a new MR-compatible microwave antenna and a standard MR-compatible radiofrequency ablation electrode for tumour ablation

MR elastography of the liver at 3.0 T in diagnosing liver fibrosis grades; preliminary clinical experience