Rustom Luma Basma O, Sharara Ala I
Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Inflamm Intest Dis. 2018 Dec;3(2):69-74. doi: 10.1159/000490054. Epub 2018 Jul 12.
Colonic diverticulosis is the most common incidental lesion found on routine colonoscopy. However, its true natural history is unclear. The aim of this review is to examine the epidemiology of colonic diverticulosis and the incidence of complications, namely acute diverticulitis and diverticular hemorrhage.
Many studies have evaluated the epidemiology and risk factors of diverticulosis. Despite the common nature of this entity, little is known about the risk of complications in asymptomatic individuals. It has been suggested that the lifetime risk of acute diverticulitis is 10-25% and that of diverticular hemorrhage is 3-5%. These risk estimates were based on older literature without accurate studies on true prevalence. Three recent retrospective observational cohort studies including subjects identified at colonoscopy have addressed this issue, providing information on the long-term risk of complications of colonic diverticulosis. Cumulative data from these studies support an incidence of acute diverticulitis of 1.5-6.0 per 1,000 patient-years and 0.46 per 1,000 patient-years for diverticular hemorrhage.
Diverticulosis is a very common condition in individuals > 50 years of age. Based on population-based colonoscopy studies, the natural history of colonic diverticulosis appears favorable with a far lower incidence of complications than previously thought.
结肠憩室病是在常规结肠镜检查中发现的最常见的偶然病变。然而，其真正的自然病程尚不清楚。本综述的目的是研究结肠憩室病的流行病学以及并发症（即急性憩室炎和憩室出血）的发生率。
许多研究评估了憩室病的流行病学和危险因素。尽管该疾病很常见，但对于无症状个体发生并发症的风险知之甚少。有人提出，急性憩室炎的终生风险为10%-25%，憩室出血的终生风险为3%-5%。这些风险估计是基于较旧的文献，没有对真实患病率进行准确研究。最近三项回顾性观察队列研究纳入了在结肠镜检查中发现的受试者，解决了这个问题，提供了关于结肠憩室病并发症长期风险的信息。这些研究的累积数据支持急性憩室炎的发生率为每1000患者年1.5-6.0例，憩室出血的发生率为每1000患者年0.46例。
憩室病在50岁以上人群中非常常见。基于人群结肠镜检查研究，结肠憩室病的自然病程似乎较好，并发症发生率远低于先前认为的水平。
