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Computerized tomography of colonic diverticulitis.

E Doringer1

  • 1Department of Radiology, Salzburg General Hospital, Austria.

Critical Reviews in Diagnostic Imaging
|January 1, 1992
PubMed
Summary

Computerized tomography (CT) is superior to contrast enema (CE) for diagnosing acute diverticulitis. CT better visualizes inflammation extent, aiding clinical decisions in this common abdominal condition.

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Area of Science:

  • Radiology
  • Gastroenterology
  • Surgical Pathology

Background:

  • Acute diverticulitis is a common cause of abdominal pain, presenting diagnostic challenges.
  • Diverticulosis affects a significant portion of the population, with a notable percentage developing acute diverticulitis requiring intervention.
  • Distinguishing diverticulosis from acute diverticulitis and assessing the inflammatory extent is crucial for patient management.

Purpose of the Study:

  • To compare the diagnostic value of computerized tomography (CT) and contrast enema (CE) in patients with acute diverticulitis.
  • To evaluate the effectiveness of each imaging modality in assessing the extent of pericolic inflammation.
  • To discuss the differential diagnoses associated with CT findings in acute diverticulitis.

Main Methods:

  • Review of existing literature comparing CT and CE for acute diverticulitis.
  • Analysis of imaging features indicative of diverticulitis, including colonic wall thickening and pericolic infiltration.
  • Discussion of the limitations of CE in evaluating the full extent of inflammation.

Main Results:

  • CT is more effective than CE in demonstrating the extent of pericolic inflammation, which is often underestimated by CE.
  • CT exhibits high sensitivity for detecting infiltration and colonic wall thickening in acute diverticulitis.
  • While sensitive, CT findings such as infiltration and wall thickening are not pathognomonic and require careful interpretation.

Conclusions:

  • CT is the preferred imaging modality for evaluating acute diverticulitis due to its superior ability to assess inflammatory extent.
  • CE is limited in its capacity to fully evaluate the inflammatory process associated with diverticulitis.
  • Further consideration of differential diagnoses is necessary when interpreting CT findings in suspected acute diverticulitis.

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