Os pacientes tratados ambulatorialmente devem ser avaliados em até 7 dias após o diagnóstico, ou antes, se houver qualquer deterioração clínica.[7]Sartelli M, Weber DG, Kluger Y, et al. 2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting. World J Emerg Surg. 2020 May 7;15(1):32.
https://wjes.biomedcentral.com/articles/10.1186/s13017-020-00313-4
http://www.ncbi.nlm.nih.gov/pubmed/32381121?tool=bestpractice.com
O American College of Physicians (ACP) recomenda encaminhar os pacientes para uma colonoscopia após um episódio de diverticulite cólica no lado esquerdo complicada, se esses pacientes não tiverem sido submetidos a uma colonoscopia recentemente. Isso descarta um câncer colorretal ou neoplasia cólica avançada se houver incerteza diagnóstica.[64]Agency for Healthcare Research and Quality (AHRQ). Comparative effectiveness review no. 233: management of colonic diverticulitis. Rockville (MD): Agency for Healthcare Research and Quality (US); 2020.
https://www.ncbi.nlm.nih.gov/sites/books/NBK563756
[91]Qaseem A, Etxeandia-Ikobaltzeta I, Lin JS, et al; Clinical Guidelines Committee of the American College of Physicians. Colonoscopy for diagnostic evaluation and interventions to prevent recurrence after acute left-sided colonic diverticulitis: a clinical guideline from the American College of Physicians. Ann Intern Med. 2022 Mar;175(3):416-31.
https://www.acpjournals.org/doi/10.7326/M21-2711
http://www.ncbi.nlm.nih.gov/pubmed/35038270?tool=bestpractice.com
A American Gastroenterological Association (AGA) recomenda a colonoscopia após um episódio de diverticulite complicada. A AGA afirma que a colonoscopia pode ser adiada se uma colonoscopia de alta qualidade recente (dentro de 1 ano) tiver sido realizada.[43]Peery AF, Shaukat A, Strate LL. AGA clinical practice update on medical management of colonic diverticulitis: expert review. Gastroenterology. 2021 Feb;160(3):906-11.e1.
https://www.gastrojournal.org/action/showPdf?pii=S0016-5085%2820%2935512-8
http://www.ncbi.nlm.nih.gov/pubmed/33279517?tool=bestpractice.com
Embora não haja uma associação causal estabelecida entre diverticulite e neoplasia colorretal, a colonoscopia de rastreamento para câncer colorretal deve ser considerada nos pacientes com mais de 50 anos com risco normal de câncer colorretal, e a uma idade mais precoce naqueles com alto risco.[64]Agency for Healthcare Research and Quality (AHRQ). Comparative effectiveness review no. 233: management of colonic diverticulitis. Rockville (MD): Agency for Healthcare Research and Quality (US); 2020.
https://www.ncbi.nlm.nih.gov/sites/books/NBK563756
[76]Fugazzola P, Ceresoli M, Coccolini F, et al. The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly. World J Emerg Surg. 2022 Jan 21;17(1):5.
https://wjes.biomedcentral.com/articles/10.1186/s13017-022-00408-0
http://www.ncbi.nlm.nih.gov/pubmed/35063008?tool=bestpractice.com
[103]Koo CH, Chang JHE, Syn NL, et al. Systematic review and meta-analysis on colorectal cancer findings on colonic evaluation after CT-confirmed acute diverticulitis. Dis Colon Rectum. 2020 May;63(5):701-9.
http://www.ncbi.nlm.nih.gov/pubmed/32271220?tool=bestpractice.com
[104]Mortensen LQ, Buciek J, Andresen K, et al. Diverticulitis does not increase the long-term risk of developing colon cancer: a systematic review and meta-analysis. Int J Colorectal Dis. 2022 Sep;37(9):1945-52.
http://www.ncbi.nlm.nih.gov/pubmed/36042030?tool=bestpractice.com