Inverted colonic diverticulum: An endoscopic examination and presentation

Abstract

Objective: We aimed to determine the frequency, morphological features, differential diagnosis, possible adverse events of inverted colonic diverticulum (ICD), which may be misdiagnosed as polyps. Methods: In all, 810 patients who underwent a colonoscopy between April 2016 and November 2019 were included in the study, and their data were evaluated retrospectively. Colonoscopic procedures were performed at a single center by the same endoscopist. Results: Among all the 810 patients, the prevalence of diverticulum was 29.58% (121/409) in men and 25.19% (n = 101/401) in women, respectively. ICD was observed in 1.73% (n = 14) of all patients, including 11 (78.57%) men (aged 63.2 ± 12.95 years [range 47–90 years]) and three women (60.3 ± 4.04 years [range 58–65 years]). Most (63.16% [12/19]) ICD lesions were localized in the sigmoid colon. And the diagnosis was confirmed by eversion using biopsy forceps in 78.95% of them. One patient developed perforation after polypectomy with hot biopsy forceps and was treated by surgical operation. Conclusions: ICD is a common lesion that may lead to serious adverse events if misdiagnosed as polyps. Differential diagnosis of ICD is crucial during the colonoscopy. © 2021 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd