[Accurate predictors for acute diverticulitis].
In a relatively high percentage of patients with a clinically suspected diverticulitis a different diagnosis is established after imaging tests, such as 'appendicitis' or 'intestinal obstruction'. The clinical diagnosis 'acute diverticulitis' is correct for between 43% and 68% of suspected patients. Strongly predictive variables for the diagnosis are tenderness in the left lower abdomen only, CRP > 50 mg/l and absence of vomiting. This triad has a positive predictive value of 97% (95% CI: 83-99) for the final diagnosis 'diverticulitis'. The negative predictive value is much lower, namely 47%: the absence of 1 of the 3 factors does not (sufficiently) exclude 'diverticulitis'. This triad can be an easy-to-use decision rule to rule in diverticulitis.
Academisch Medisch Centrum, Afd. Chirurgie, Amsterdam, The Netherlands. m.a.boermeester@amc.uva.nl
Marja A
MA
Boermeester
Jaap
J
Stoker
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000032:analysis; D003937:Diagnosis, Differential; D004238:Diverticulitis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D011237:Predictive Value of Tests
D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein