This study evaluate the prevalence of advanced colonic neoplasia (ACN) in acute diverticulitis. A sub-analysis of complicated and uncomplicated acute diverticulitis will be made in order to determinate whether there are differences of advanced colonic neoplasia (ANC) prevalence in both groups and to assess if a colonoscopy is necessary.
This is a prospective study that eliminates biases in the selection, design and variability of retrospective studies to reliably assess the global prevalence of advanced colon neoplasia (ACN) and the difference in prevalence among populations with complicated and uncomplicated acute diverticulitis diagnosed by computed tomography. Another objective is to assess the diagnostic prediction of computed tomography to detect ACN in acute diverticulitis. It also aims to assess the safety and quality of colonoscopy in a patient recently diagnosed with acute diverticulitis. Finally, it aims to study whether other diagnostic tools such as the presence of clinical risk symptoms or the performance of fecal biological tests could help in narrowing the indication of colonoscopy in this clinical scenario.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
313
Anal introduction of a long, flexible, tubular instrument about 1/2-inch in diameter that transmits an image of the lining of the colon so the doctor can examine it for any abnormalities
A test for fecal occult blood looks for blood in your feces. It can be a sign of a problem in the digestive system, such as a polyp or cancer in the colon.
Calprotectin is a protein released by neutrophils. When there is inflammation in the colon, neutrophils move to the area and release calprotectin, resulting in an increased level in the stool. This test measures the level of calprotectin in stool as a way to detect inflammation and lesions in the colon.
Parc de Salut Mar. Hospital del Mar.
Barcelona, Spain
Presence of ACN
For our study, ANC is all colonic lesions that are advanced adenoma or colorectal cancer. Advanced adenoma is defined as that adenoma with size\> 10mm, villous component in\> 25% and / or high-grade dysplasia or all serrated lesions\> 10mm with or without dysplasia. Colonoscopy is the gold standard for ANC detection.
Time frame: At the moment of colonoscopy.
CT predictive value for ACN detection
Assessment of diagnostic prediction of computed tomography to detect ANC in acute diverticulitis.
Time frame: At the moment of colonoscopy.
Clinical symptoms predictive value for ANC detection
Assessment of diagnostic prediction of clinical symptoms to detect ANC in acute diverticulitis.
Time frame: At the moment of colonoscopy.
Colonoscopy quality
A quality colonoscopy will be considered as a complete colonoscopy, with an adequate preparation according to the Boston scale (score greater than or equal to 2 in all segments) and with resection of all polyps \<20mm detected.
Time frame: At the moment of colonoscopy.
Colonoscopy security
Assessment of complications arising from colonoscopy. Mayor complication of colonoscopy is defined as the presence of perforation, hemorrhage, postpolypectomy syndrome, thromboembolic accident, acute myocardial infarction and / or death, and minor complication of colonoscopy for the rest of the events.
Time frame: 30 days post-colonoscopy.
FIT predictive value for ANC detection
Assessment of diagnostic prediction of FIT to detect ANC in acute diverticulitis.
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Time frame: At the moment of colonoscopy.
Fecal calprotectin test predictive value for ANC detection
Assessment of diagnostic prediction of fecal calprotectin test to detect ANC in acute diverticulitis.
Time frame: At the moment of colonoscopy.