American Board of Internal Medicine (ABIM) Certification Practice Exam

What procedure is recommended after recovering from diverticulitis due to the possibility of a sigmoid cancer?

1. Colonoscopy

2. Abdominal ultrasound

3. CT scan of the abdomen

4. Flexible sigmoidoscopy

The correct answer is: Colonoscopy

After recovering from diverticulitis, a colonoscopy is recommended primarily to evaluate the colon for any potential lesions, including sigmoid cancer. Diverticulitis can potentially obscure underlying malignancies, especially since symptoms of diverticulitis and cancer can overlap. A colonoscopy allows direct visualization of the colon and is the gold standard for detecting polyps, tumors, and any suspicious lesions that may not have been apparent during the acute phase of diverticulitis. Not only does it provide the ability to take biopsies of any suspicious areas, but it also plays a pivotal role in surveillance for patients who have had diverticular disease. This procedure is essential in establishing a baseline and monitoring for any changes over time, particularly in the sigmoid colon, where diverticulosis and tumors are more commonly found. Other imaging or diagnostic methods, such as abdominal ultrasound, CT scan of the abdomen, or flexible sigmoidoscopy, may have their own clinical roles but do not offer the same comprehensive evaluation of the entire colon as a colonoscopy. An abdominal ultrasound might detect complications like abscesses, while a CT scan can help assess diverticulitis itself but is not primarily designed for cancer screening. A flexible sigmoidoscopy is limited to examining the rectum and lower third