Article

[The value of CT for the diagnosis of acute diverticulitis].

Abteilung für Radiodiagnostik, Radiologische Klinik, Universitätsklinikum Heidelberg.
Der Radiologe (impact factor: 0.61). 02/2003; 43(1):51-8. DOI:10.1007/s00117-002-0849-4 pp.51-8
Source: PubMed

ABSTRACT In acute diverticulitis accurate diagnosis and staging are mandatory to decide on the treatment of the patient. The impact of computed tomography (CT) on the treatment of acute diverticulitis will be discussed.
CT is performed after distension of the distal colon by means of positive,water-soluble contrast media to depict intestinal perforation or penetration. Then intravenous contrast material is administered and spiral scanning is repeated to judge enhancement patterns of the abdominal structures/organs especially of the intestinal wall and to diagnose abscess formation. CT-morphologies of different stages of acute diverticulitis will be described.
CT imaging is the only diagnostic method that in case of an acute diverticulitis combines safety with accuracy. On the one hand, it is fast and therefore safe with respect to patient control and on the other hand, it allows accurate staging of the inflammatory process reaching a sensitivity and specificity of up to 100%, each. CT is an appropriate tool to diagnose acute diverticulitis complicated by abscess formation, intestinal penetration or perforation and therefore has direct impact on the treatment of the patient.
If acute diverticulitis is suspected CT is the method of choice for imaging because of its high impact on the choice of therapy and on the management of complications.

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    Article: Computed tomography in the imaging of colonic diverticulitis.
    O Buckley, T Geoghegan, D S O'Riordain, I D Lyburn, W C Torreggiani
    [show abstract] [hide abstract]
    ABSTRACT: Colonic diverticulitis occurs when diverticula within the colon become infected or inflamed. It is becoming an increasingly common cause for hospital admission, particularly in western society, where it is linked to a low fibre diet. Symptoms of diverticulitis include abdominal pain, diarrhoea and pyrexia, however, symptoms are often non-specific and the clinical diagnosis may be difficult. In addition, elderly patients and those taking corticosteroids may have limited findings on physical examination, even in the presence of severe diverticulitis. A high index of suspicion is required in such patients in order to avoid a significant delay in arriving at the correct diagnosis. Imaging plays an important role in establishing an early and correct diagnosis. In the past, contrast enema studies were the principal imaging test used to make the diagnosis. However, such studies lack sensitivity and have limited success in identifying abscesses that may require drainage. Conversely computed tomography (CT) is both sensitive and specific in making a diagnosis of diverticulitis. In addition, it is the imaging technique of choice in depicting complications such as perforation, abscess formation and fistulae. CT-guided drainage of diverticular abscesses helps to reduce sepsis and to permit a one-stage, rather than two-stage, surgical operation. The purpose of this review article is to discuss the role of CT in the imaging of diverticulitis, describe the CT imaging features and complications of this disease, as well as review the impact and rationale of CT imaging and intervention in the overall management of patients with diverticulitis.
    Clinical Radiology 12/2004; 59(11):977-83. · 1.95 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

abdominal structures/organs
 
abscess formation
 
acute diverticulitis
 
acute diverticulitis accurate diagnosis
 
appropriate tool
 
computed tomography
 
CT imaging
 
diagnose abscess formation
 
diagnose acute diverticulitis
 
different stages
 
imaging
 
inflammatory process
 
intestinal penetration
 
intestinal perforation
 
intestinal wall
 
intravenous contrast material
 
judge enhancement patterns
 
one hand
 
patient control
 
spiral scanning
 

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