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Open Access
CC BY 4.0 · Endoscopy
DOI: 10.1055/a-2587-4966
Innovations and brief communications

Endoscopic direct diverticulitis therapy for acute uncomplicated diverticulitis

Jian-Zhen Ren
1   Department of Gastroenterology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China
,
Jun Cai
1   Department of Gastroenterology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China
,
Bo Li
1   Department of Gastroenterology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China
,
Guang Yang
1   Department of Gastroenterology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China
,
Su-Huan Liao
1   Department of Gastroenterology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China
,
Jia-Kuan Chen
2   Department of Radiology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China
,
Yi-Tian Guo
1   Department of Gastroenterology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China
,
Yang-Bor Lu
3   Department of Digestive Disease, Xiamen Chang Gung Hospital, Hua Qiao University, Xiamen, China
4   Endoscopy Center, Xiamen Chang Gung Hospital, Hua Qiao University, Xiamen, China
,
Si-Lin Huang
1   Department of Gastroenterology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China
› Institutsangaben
Gefördert durch: The Clinical Teaching Base Teaching Reform Research Project of School of Medicine in Shenzhen University YXBJG202426
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Abstract

Background

The global prevalence of acute uncomplicated diverticulitis is increasing, and patient care for this condition is experiencing a paradigm shift. This study evaluated the diagnostic and therapeutic value of endoscopic direct diverticulitis therapy (EDDT) using cholangioscope-assisted colonoscopy for acute uncomplicated diverticulitis.

Methods

Patients with computed tomography-confirmed acute uncomplicated diverticulitis (Hinchey stage Ia or Ib) who underwent EDDT between July 2023 and December 2024 were included. The technical success rate of EDDT, procedure time, endoscopic findings, symptom resolution, and recurrence were documented.

Results

12 patients (mean age 45.2 [SD 10.1] years, 10 males) underwent EDDT. Technical success was achieved in all 12 patients (100%). Cholangioscope-assisted colonoscopy revealed fecaliths with pus in seven patients, copious purulent collection in four, edematous inflammatory mucosa in five, and bleeding in one. Corresponding treatments were applied without complications. Abdominal pain resolved immediately after EDDT, and inflammatory parameters returned to normal. No recurrences were reported over a mean follow-up of 4 months (range 1–10 months).

Conclusions

EDDT utilizing cholangioscope-assisted colonoscopy was a feasible alternative treatment for acute uncomplicated diverticulitis, offering diagnostic and therapeutic advantages through direct visualization. Although preliminary results are promising, further studies with larger cohorts are warranted to confirm its efficacy and long-term outcomes.



Publikationsverlauf

Eingereicht: 14. Januar 2025

Angenommen nach Revision: 11. April 2025

Accepted Manuscript online:
15. April 2025

Artikel online veröffentlicht:
14. Mai 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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