PAEA Surgery End Of Rotation (EOR) Practice Exam

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Why is colonoscopy not recommended during an episode of diverticulitis?

Insufficient evidence of effectiveness
Risk of possible perforation
Inadequate patient preparation
High cost of the procedure

The correct answer is: Risk of possible perforation

Colonoscopy is not recommended during an episode of diverticulitis primarily due to the associated risk of possible perforation. During acute diverticulitis, the bowel wall may be inflamed and weakened, which can increase the likelihood of perforation when subjected to the pressure and manipulation that occur during the colonoscopy procedure. This complication can lead to significant morbidity, including peritonitis and sepsis, necessitating surgical intervention. Performing a colonoscopy in an inflamed segment of the colon poses a considerable risk, hence most guidelines recommend rescheduling the procedure until the diverticulitis has resolved and the inflammation has subsided. This caution is essential to ensure patient safety and minimize the risk of severe complications. While other factors such as preparation or costs could play a role in clinical practice decisions, the primary concern is the immediate risk of perforation associated with the inflamed bowel during diverticulitis episodes.