In investigating colorectal disorders at Wellington Hospital in New Zealand, Sim and Scobie (1982) analysed 1118 air contrast enemas and found 395 with diverticular disease. Complicated diverticular disease was rare although an analysis of specific symptoms with uncomplicated diverticular disease, such as pain, bowel habit and bleeding, was no different from patients with negative barium enemas.
In 1975, air contrast barium enemas became routine, allowing increased accuracy compared with a standard barium enema. Diverticular disease increased with age from 4% in the 30s rising to 66% in the 90s. Diverticular disease affected the sigmoid colon severely in 13 patients, moderately in 303 patients and to a minor degree in 70 patients.
Gross disease was found in 13 patients involving most of the colon. Atypical sites were found in eight patients, four in the ascending colon, three in the splenic flexure and one in the hepatic flexure. Of the complicated diverticular disease, one suggested an involvement of a pelvic colorectal cancer, one with a vesicolic fistula demonstrating gas in the bladder, one with stenosis, one perforated and two with masses.
The incidence of diverticular disease in New Zealand concurs with postmortem findings in Australia, the UK and France (Debray et al., 1961; Parks, 1968; Hughes, 1969). Although large bowel disease such as cancer, polyps, inflammatory bowel disease and diverticular disease are noted to be diseases of the western world resulting from fibre deficiency, there has been no in-depth analysis in New Zealand, although the paper by Sim and Scobie (1982) has begun to address these issues.
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