Document Detail

Computed tomography in acute left colonic diverticulitis.
MedLine Citation:
PMID:  9112910     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The use of computed tomography (CT) in acute left colonic diverticulitis remains controversial. The purpose of this study was to define the value of CT both during the acute phase of inflammation and, later, to indicate secondary complications after successful medical treatment. METHODS: Some 423 patients with radiologically or histologically proven diverticulitis were studied prospectively from 1986 to 1995. Diverticulitis was considered moderate when CT showed localized thickening of the colonic wall (5 mm or more) and inflammation of pericolic fat; it was considered severe when abscess and/or extraluminal air and/or extraluminal contrast were observed. RESULTS: The sensitivity of CT was 97 per cent. Of 42 patients who failed conservative treatment, 32 had severe diverticulitis on CT, compared with 74 (24 per cent) of 303 who had successful conservative treatment (P < 0.0001). After a median follow-up of 46 months, 60 (20 per cent) of 300 patients had secondary complications despite initially successful conservative treatment: 28 (47 per cent) of these had initial severe diverticulitis on CT compared with 44 (19 per cent) of 236 patients who had no complications (P < 0.0001). CONCLUSION: Abscess formation and extracolonic contrast or gas are findings that may be used to predict failure of medical treatment during the first admission and a high risk of secondary complications after initially successful medical management of acute diverticulitis.
P Ambrosetti; M Grossholz; C Becker; F Terrier; P Morel
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  84     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-05-21     Completed Date:  1997-05-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  532-4     Citation Subset:  AIM; IM    
Division of General Surgery, University Hospital of Geneva, Switzerland.
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MeSH Terms
Acute Disease
Aged, 80 and over
Diverticulitis, Colonic / radiography*,  surgery
Middle Aged
Prospective Studies
Sensitivity and Specificity
Surgical Procedures, Elective
Tomography, X-Ray Computed*
Treatment Failure
Comment In:
Br J Surg. 1997 Oct;84(10):1481   [PMID:  9361624 ]

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