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Computed tomography in acute left colonic diverticulitis

P Ambrosetti1, M Grossholz, C Becker

  • 1Division of General Surgery, University Hospital of Geneva, Switzerland.

The British Journal of Surgery
|April 1, 1997
PubMed
Summary
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Computed tomography (CT) effectively identifies severe acute left colonic diverticulitis, predicting treatment failure and secondary complications. This imaging is crucial for managing diverticulitis patients and assessing long-term outcomes.

Area of Science:

  • Gastroenterology
  • Radiology
  • Surgical Oncology

Background:

  • Computed tomography (CT) use in acute left colonic diverticulitis is debated.
  • CT's role in acute inflammation and predicting secondary complications requires definition.

Purpose of the Study:

  • To determine the value of CT in acute diverticulitis.
  • To assess CT's ability to predict secondary complications post-treatment.

Main Methods:

  • Prospective study of 423 patients with proven diverticulitis (1986-1995).
  • Diverticulitis severity classified by CT: moderate (wall thickening, fat inflammation) vs. severe (abscess, extraluminal air/contrast).

Main Results:

  • CT sensitivity was 97%.

Related Experiment Videos

  • Severe diverticulitis on CT predicted failure of conservative treatment (32/42 patients) and higher risk of secondary complications (28/60 patients).
  • P < 0.0001 for both findings.

    • Conclusions:

    • CT findings of abscess or extracolonic gas/contrast predict medical treatment failure.
    • These CT findings indicate a high risk for secondary complications after initial successful management.