title: Acute Perforated Diverticulitis: Assessment With Multidetector Computed Tomography.
abstract: Colonic diverticulitis is a common condition in the western population. Complicated diverticulitis is defined as the presence of extraluminal air or abscess, peritonitis, colon occlusion, or fistulas. Multidetector row computed tomography (MDCT) is the modality of choice for the diagnosis and the staging of diverticulitis and its complications, which enables performing an accurate differential diagnosis and addressing the patients to a correct management. MDCT is accurate in diagnosing the site of perforation in approximately 85% of cases, by the detection of direct signs (focal bowel wall discontinuity, extraluminal gas, and extraluminal enteric contrast) and indirect signs, which are represented by segmental bowel wall thickening, abnormal bowel wall enhancement, perivisceral fat stranding of fluid, and abscess. MDCT is accurate in the differentiation from complicated colon diverticulitis and colon cancer, often with a similar imaging. The computed tomography-guided classification is recommended to discriminate patients with mild diverticulitis, generally treated with antibiotics, from those with severe diverticulitis with a large abscess, which may be drained with a percutaneous approach.
authors.affiliation: Department of Emergency Radiology, S. Camillo Hospital, Rome, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Sessa
authors.affiliation: Department of Emergency Radiology, S. Camillo Hospital, Rome, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Galluzzo
authors.affiliation: Department of Emergency Radiology, S. Camillo Hospital, Rome, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Ianniello
authors.affiliation: Department of Radiology, Cardarelli Hospital, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pinto
authors.affiliation: Department of Emergency Radiology, S. Camillo Hospital, Rome, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Trinci
authors.affiliation: Department of Emergency Radiology, S. Camillo Hospital, Rome, Italy. Electronic address: vmiele@sirm.org.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Miele
mesh_terms: D000208:Acute Disease; D004239:Diverticulitis, Colonic / Q000150:complications / Q000000981:diagnostic imaging*; D004632:Emergency Medical Services / Q000379:methods; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology; D061330:Multidetector Computed Tomography / Q000379:methods*; D056888:Patient Positioning / Q000379:methods; D011856:Radiographic Image Enhancement / Q000379:methods*; D011860:Radiography, Abdominal / Q000379:methods*