Bildgebende Diagnostik der Kolondivertikulose und ihrer Komplikationen

Abstract

Imaging Diagnostics of Colonic Diverticulosis and Its Complications Radiodiagnostic imaging modalities in diverticulosis and diverticulitis for visualization of complications include supine radiograph of the abdomen, ultrasonography, barium studies of the colon, in case of diverticulitis and suspicion of penetration only water-soluble contrast medium studies, spiral-CT and magnetic resonance imaging (MRI). In cases of endoscopic failure to localize diverticular bleedings because of massive intraluminal blood clots, selective and superselective angiography is indicated for localization of the bleeding source and, if necessary, transcatheter embolization or vasopressin infusion to stop the bleeding. In endoscopical failure to pass the stenosis of inflammatory origin because of diverticulitis, only water-soluble contrast medium studies are indicated, mainly to visualize the post-stenotic areas of the colon orally to the stenosis. In cases of penetration or suspected perforation, fistulas in surrounding organ structures like adjacent bowel loops, urinary bladder or muscle tissue, ultrasound or spiral-CT are the favorite imaging modalities. Up to now, MRI does not play the role as ultrasound or spiral-CT do.