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Colonoscopy can miss diverticula of the left colon identified by barium enema.

AbstractAIM:
To identify the diagnostic value of colonoscopy for diverticulosis as determined by barium enema.
METHODS:
A total of 65 patients with hematochezia who underwent colonoscopy and barium enema were analyzed, and the diagnostic value of colonoscopy for diverticula was assessed. The receiver operating characteristic area under the curve was compared in relation to age (< 70 or ≥ 70 years), sex, and colon location. The number of diverticula was counted, and the detection ratio was calculated.
RESULTS:
Colonic diverticula were observed in 46 patients with barium enema. Colonoscopy had a sensitivity of 91% and specificity of 90%. No significant differences were found in the receiver operating characteristic area under the curve (ROC-AUC) for age group or sex. The ROC-AUC of the left colon was significantly lower than that of the right colon (0.81 vs 0.96, P = 0.02). Colonoscopy identified 486 colonic diverticula, while barium enema identified 1186. The detection ratio for the entire colon was therefore 0.41 (486/1186). The detection ratio in the left colon (0.32, 189/588) was significantly lower than that of the right colon (0.50, 297/598) (P < 0.01).
CONCLUSION:
Compared with barium enema, only half the number of colonic diverticula can be detected by colonoscopy in the entire colon and even less in the left colon.
AuthorsRyota Niikura, Naoyoshi Nagata, Takuro Shimbo, Junichi Akiyama, Naomi Uemura
JournalWorld journal of gastroenterology (World J Gastroenterol) Vol. 19 Issue 15 Pg. 2362-7 (Apr 21 2013) ISSN: 2219-2840 [Electronic] United States
PMID23613630 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Barium
  • Barium Sulfate
Topics
  • Aged
  • Area Under Curve
  • Barium
  • Barium Sulfate (pharmacology)
  • Colon (pathology)
  • Colonoscopy (methods)
  • Diverticulum, Colon (diagnosis)
  • Enema (methods)
  • Female
  • Humans
  • Male
  • Middle Aged
  • ROC Curve
  • Retrospective Studies
  • Sensitivity and Specificity

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