Computed tomography in the evaluation of diverticulitis

• Published in: Radiology Vol. 152; no. 2; p. 491
• Main Authors: Hulnick, D H, Megibow, A J, Balthazar, E J, Naidich, D P, Bosniak, M A
• Format: Journal Article
• Language: English
• Published: United States 01.08.1984
• Subjects: Adult; Aged; Diverticulitis, Colonic - diagnostic imaging; Enema; Female; Humans; Male; Middle Aged; Tomography, X-Ray Computed
• ISSN: 0033-8419
• DOI: 10.1148/radiology.152.2.6739821

Computed tomography (CT) was performed in 43 cases of colonic diverticulitis and compared with the contrast-enema examination (CE) in 37 patients. Findings on CT included inflammation of the pericolic fat in 98% of cases, diverticula in 84%, thickening of the colon wall in 70%, a pericolic abscess in 35%, peritonitis in 16%, a fistula in 14%, colon obstruction in 12%, and intramural sinus tracts in 9%. Secondary findings included a distant abscess in 12% and ureteral obstruction in 7%. In addition to detecting ureteral and bladder involvement and distant abscess formation, CT was preferable for demonstrating the extent of pericolic inflammation, which was underestimated with CE in 41% of patients. Differential diagnosis of the CT findings is discussed. The authors indicate that CT should be the initial procedure in patients with suspected diverticulitis, particularly when CE is contraindicated.