Differences between computed tomoghaphy and surgical findings in acute complicated diverticulitis

Torre, Marco La; Mingoli, Andrea; Brachini, Gioia; Lanciotti, Silvia; Casciani, Emanuele; Speranza, Attilio; Mastroiacovo, Ilaria; Frezza, Barbara; Cirillo, Bruno; Costa, Gianluca; Sapienza, Paolo

doi:10.1016/j.asjsur.2019.07.016

Cited by 5 publications

(5 citation statements)

References 27 publications

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“…To the best of our knowledge, there are only two recently published studies that evaluate the newly proposed CDD algorithm in correlation with intraoperative findings [26,27]. While La Torre et al found a high interobserver agreement of CT data between two radiologists (k = 0.905), the concordance of imaging and surgical findings was rather weak (k = 0.213 and 0.248) [26]. In comparison, correlation with surgical findings was much higher in our study.…”

Section: Discussioncontrasting

confidence: 66%

“…Similarly, in a prospective study of 120 patients with suspected left-sided diverticulitis, CT with intravenous and rectal contrast had an accuracy of 98 %, a sensitivity of 97 %, and a specificity of 98 % [13]. To the best of our knowledge, there are only two recently published studies that evaluate the newly proposed CDD algorithm in correlation with intraoperative findings [26,27]. While La Torre et al found a high interobserver agreement of CT data between two radiologists (k = 0.905), the concordance of imaging and surgical findings was rather weak (k = 0.213 and 0.248) [26].…”

Section: Discussionmentioning

confidence: 95%

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To Fill or Not to Fill? – Value of the Administration of Positive Rectal Contrast for CT Evaluation of Diverticular Disease of the Colon

Meyer

Schmidbauer

Wacker

et al. 2021

Rofo

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Purpose To assess the value of the administration of positive rectal contrast at CT in patients referred for suspected diverticular disease (DD) of the colon. Materials and Methods 460 patients (253 male, 207 female; median age 62 years; interquartile range 24) with clinical suspicion of DD of the colon were included in this retrospective IRB-approved study. CT was performed with i. v. contrast only (n = 328, group M1), i. v. + positive rectal contrast (n = 82, group M2), neither i. v. nor rectal contrast (n = 32, group S1), or positive rectal contrast only (n = 19, group S2). Two readers in consensus evaluated all CT datasets concerning diagnosis of DD (yes/no) and categorized findings (classification of diverticular disease (CDD)). Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values for the diagnosis of DD were calculated for all groups, using either clinical follow-up (n = 335) or intraoperative findings (n = 125) as the reference standard. In patients undergoing surgery, radiological staging of DD was correlated with the histopathology (weighted Cohen-k). Results 224 patients (48.7 %) were diagnosed with DD. The sensitivity, specificity, PPV, and NPV were as follows. Group M1 / M2: 92 %/92 %, 97 %/94 %, 96 %/96 %, 94 %/89 %, respectively; group S1 / S2: 94 %/86 %, 93 %/80 %, 94 %/92 %, 93 %/67 %, respectively. Radiological staging and histopathology correlated substantially in all groups (k = 0.748–0.861). Conclusion Abdominal CT had a high sensitivity and specificity for the diagnosis of DD. Disease staging correlated well with the findings at surgery. Additional positive rectal contrast administration did not have a significant advantage and may therefore be omitted in patients with suspected DD. Key Points: Citation Format

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Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 95%

To Fill or Not to Fill? – Value of the Administration of Positive Rectal Contrast for CT Evaluation of Diverticular Disease of the Colon

Meyer

Schmidbauer

Wacker

et al. 2021

Rofo

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“…Therefore, for the purpose of this study, we considered that a κ value greater than 0.7 implied acceptable agreement, a κ value greater than 0.8 good agreement, and a κ value greater than 0.9 excellent agreement. 9,10 The sensitivity, specificity, PPV, and NPV with rRT-PCR as the reference standard were calculated between chest CT and LUS. Positive and negative likelihood ratios (LRs) measured the diagnostic accuracy.…”

Section: Discussionmentioning

confidence: 99%

“…A κ value of 1.000 indicated perfect agreement, a κ value of 0.000 no agreement, and a κ value of −1.000 complete disagreement. Therefore, for the purpose of this study, we considered that a κ value greater than 0.7 implied acceptable agreement, a κ value greater than 0.8 good agreement, and a κ value greater than 0.9 excellent agreement 9,10 . The sensitivity, specificity, PPV, and NPV with rRT‐PCR as the reference standard were calculated between chest CT and LUS.…”

Section: Methodsmentioning

confidence: 99%

Is Lung Ultrasound Imaging a Worthwhile Procedure for Severe Acute Respiratory Syndrome Coronavirus 2 Pneumonia Detection?

Fonsi

Sapienza

Brachini

et al. 2020

J of Ultrasound Medicine

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Objectives We compared 2 imaging modalities in patients suspected of having coronavirus disease 2019 (COVID‐19) pneumonia. Blinded to the results of real‐time reverse transcriptase polymerase chain reaction (rRT‐PCR) testing, lung ultrasound (LUS) examinations and chest computed tomography (CT) were performed, and the specific characteristics of these imaging studies were assessed. Methods From March 15, 2020, to April 15, 2020, 63 consecutive patients were enrolled in this prospective pilot study. All patients underwent hematochemical tests, LUS examinations, chest CT, and confirmatory rRT‐PCR. The diagnostic performance of LUS and chest CT was calculated with rRT‐PCR as a reference. The interobserver agreement of radiologists and ultrasound examiners was calculated. Ultrasound and CT features were compared to assess the sensitivity, specificity, positive predictive value, and negative predictive value. Positive and negative likelihood ratios measured the diagnostic accuracy. Results Nineteen (30%) patients were COVID‐19 negative, and 44 (70%) were positive. No differences in demographics and clinical data at presentation were observed among positive and negative patients. Interobserver agreement for CT had a κ value of 0.877, whereas for LUS, it was 0.714. The sensitivity, specificity, positive predictive value, and negative predictive value of chest CT for COVID‐19 pneumonia were 93%, 90%, 85%, and 95%, respectively; whereas for LUS, they were 68%, 79%, 88%, and 52%. On receiver operating characteristic curves, area under the curve values were 0.834 (95% confidence interval, 0.711–0.958) and 0.745 (95% confidence interval, 0.606–0.884) for chest CT and LUS. Conclusions Lung ultrasound had good reliability compared to chest CT. Therefore, our results indicate that LUS may be used to assess patients suspected of having COVID‐19 pneumonia.

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“…seems indispensible for the management of the wide spectrum of manifestations and many treatment modalities embraced by the term "diverticular disease" (38). While the Hinchey Classification remains the most authoritative, its still insufficient to determine the best treatment option for diverticular disease (36). In our view, nowadays this classification has only historical interest (37).…”

Section: Hinchey Classificationmentioning

confidence: 99%

Diverticular Disease of the Colon

Chakhvadze

Fedotova

Chakhvadze³

2020

Acta Chirurgica Latviensis

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SummaryIntroductionIn the past decade, approaches to understanding epidemiology and treating diverticular disease have changed significantly. Many of the principles used earlier have lost their relevance at the moment. In the near future, we can expect an increase in cases of the disease, given the general population aging. Moreover, the number of surgical operations performed on diverticulosis increases annually. The number of complications are worsening the prognosis for a given disease increasing the risk of death results.The aim of the studyA detailed scientific review is presented on the topic “Diverticular Colon Disease”. The paper primarily uses the guidelines of World Journal of Emergency Surgery (2016), as well as Guidelines of the American Association of Gastroenterologists and Clinical guidelines for the diagnosis and treatment of adult patients with diverticular colon disease developed by the expert committee of the All–Russian Public Organization “Association of Coloproctologists of Russia”. The work gives the definition of a diverticulum, diverticulosis, and diverticulitis of the colon. The issues of prevalence and frequency of occurrence of this pathology in various age and ethnic groups in developed and developing countries are reflected. The modern views on the etiology and pathogenesis of the disease are disclosed, taking into account the views of modern scholars and international guidelines. Finally, the work analyses case report on the complicated diverticular disease.Material and MethodsThe search for sources was performed in the PUBMED, PUBMED Central, Google Scholar and E–Library databases by keywords: colon diverticulosis, diverticulitis, as well as their Russian counterparts. The selection of sources was mainly limited to 2000–2020. Authors declare that the research was conducted according to the principles of the World Medical Association Declaration of Helsinki “Ethical Principles for Medical Research Involving Human Subjects. Informed consent was not received due to the nature of the study.Results and ConclusionIn the past decade, approaches to understanding epidemiology and treating diverticular disease has changed. Many of the principles used earlier have lost their relevance at the moment. At the same time, a careful study of the etiological factors, pathophysiological mechanisms and cause–effect relationships in the development of this pathology is required. Improving diagnostic methods, early prevention and new approaches to treatment can reduce the risk of death in this disease.

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Differences between computed tomoghaphy and surgical findings in acute complicated diverticulitis

Cited by 5 publications

References 27 publications

To Fill or Not to Fill? – Value of the Administration of Positive Rectal Contrast for CT Evaluation of Diverticular Disease of the Colon

To Fill or Not to Fill? – Value of the Administration of Positive Rectal Contrast for CT Evaluation of Diverticular Disease of the Colon

Is Lung Ultrasound Imaging a Worthwhile Procedure for Severe Acute Respiratory Syndrome Coronavirus 2 Pneumonia Detection?

Diverticular Disease of the Colon

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