[Which imaging in case of sigmoid diverticulitis? The value of ultrasound (Conventional B-mode in combination with hydrocolonsonography and colour flow Doppler) in comparison to the well-established modalities like contrast enema and helical computertomography].
Sigmoid diverticulitis is in case of complications like perforation, abscess and peritonitis a life-threatening disease. A diagnostic work up with high sensitivity is mandatory. In a prospective study upon 247 patients with the possible diagnosis of acute diverticulitis ultrasound is a screening method with a high specificity (97 %) and leads in combination with the hydrocolonsonography and the colour flow doppler to a high sensitivity (76 %). Without any typical findings in ultrasound, helical CT scan is the best method in the evaluation of the acute diverticulitis (sensitivity and specificity 100 %), because contrast enema is inferior to CT in the evaluation of abscesses (6 %) and perforation (53 %). CT has in case of perforation and of abscesses a sensitivity of 90 % and 100 %, while ultrasound has a sensitivity of 12 % to perforation and of 39 % to abscesses.
Moll
R
R
Abteilung für Röntgendiagnostik, Chirurgische Klinik und Poliklinik der Universität Würzburg, Germany.
Mittelkötter
U
U
Reith
H B
HB
Schindler
G
G
Thiede
A
A
D000038:Abscess / Q000175:diagnosis / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003973:Diatrizoate / Q000031:analogs & derivatives; D004239:Diverticulitis, Colonic / Q000175:diagnosis* / Q000601:surgery; D019160:Endosonography; D004733:Enema; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis / Q000601:surgery; D008239:Lysine / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012422:Rupture, Spontaneous / Q000175:diagnosis / Q000601:surgery; D012680:Sensitivity and Specificity; D012810:Sigmoid Diseases / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color
D003287:Contrast Media; D003973:Diatrizoate; C026176:Peritrast 400 comp; D008239:Lysine