Computerized tomography of colonic diverticulitis

In this review article, the value of computerized tomography (CT) vs. contrast enema (CE) in patients with acute diverticulitis is discussed. Acute diverticulitis is a frequent differential diagnosis in abdominal disease. Approximately 15 to 30% of all patients with diverticulosis develop diverticulitis, whereby approximately 21% of these must undergo surgery. The clinical as well as the radiographical differential diagnosis between diverticulosis and diverticulitis often poses a great problem. While the contrast enema demonstrates the changes of the intestinal lumen, the true extent of the inflammatory process cannot be estimated. Numerous studies have shown that CT is preferable in demonstrating the extent of pericolic inflammation, which is often underestimated with the contrast enema. Within the range of computer-tomographical symptoms, infiltration and colonic wall thickening show a high sensitivity. These CT symptoms are not pathognomonic. The differential diagnosis of the findings with CT is discussed.