Ultrasound diagnosis of diverticulitis

Abboud, Michael E.; Frasure, Sarah E.; Stone, Michael B.

doi:10.5847/wjem.j.1920-8642.2016.01.015

Cited by 12 publications

(16 citation statements)

References 14 publications

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“…In the literature, it is reported that, to diagnose acute diverticulitis, at least one diverticulum should be identified. 8 As reported by Wilson and Toi, 30 they observed diverticula in only 32 patients of 46 with a proven diagnosis of acute diverticulitis and in 3 of the 16 patients with pericolic inflammatory masses or abscesses. In our experience, diverticula identification during POCUS is not mandatory for a diagnosis of acute diverticulitis.…”

Section: Discussionmentioning

confidence: 80%

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Surgeon-performed ultrasound for the staging of acute diverticulitis: Preliminary results of a prospective study

Zago

Biloslavo

Mariani

et al. 2021

J Trauma Acute Care Surg

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Although contrast-enhanced abdominal computed tomography (CEACT) is still considered the criterion standard for the assessment of suspected acute diverticulitis, in recent years, the use of point-of-care ultrasound (POCUS) has been spreading more and more in this setting. The aim of this study was to compare CEACT to POCUS for the diagnosis and staging of suspected acute diverticulitis. METHODS:This is a prospective study conducted on 55 patients admitted to the emergency department of two Italian Hospitals with a clinical suspicion of acute diverticulitis between January 2014 and December 2017. All the patients included underwent POCUS first and CEACT immediately afterward, with the diagnosis and the staging reported according to the Hinchey (H) classification modified by Wasvary et al.[Wasvary H, Turfah F, Kadro O, Beauregard W. Same hospitalization resection for acute diverticulitis. Am Surg. 1999;65:632-635.] Three surgeons performed all the POCUS, and the same two radiologists retrospectively analyzed all the CEACT images. The radiologists were informed of the clinical suspicion but unaware of the POCUS findings. The CEACTwas used as the criterion standard for the comparison. RESULTS:The final cohort included 30 females (55%) and 25 males (45%). The median age was 62 years (range, 24-88 years), and the median body mass index was 26 kg/m 2 (range, 19-42 kg/m 2 ). Forty-six of 55 patients had a confirmed diagnosis of acute diverticulitis on both POCUS and CEACT, whereas, in 7 patients, the diagnosis was not confirmed by both methods. Point-of-care ultrasound sensitivity and specificity were 98% and 88%, respectively. Point-of-care ultrasound positive and negative predictive values were 98% and 88%, respectively. Point-of-care ultrasound accuracy was 96%. Point-of-care ultrasound classified 33 H1a, 11 H1b, 1 H2, and 1 H3 acute diverticulitis. This staging was confirmed in all patients but three (93%) by CEACT. CONCLUSION:Point-of-care ultrasound appeared a reliable technique for the diagnosis and the staging of clinically suspected H1 and H2 acute diverticulitis. It could contribute in saving time and resources and in avoiding unnecessary radiation exposure to most patients.

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Section: Discussionmentioning

confidence: 80%

“…The examination consisted of three phases: the first two were completed using a curvilinear probe (1-8 MHz), which was later switched to a linear probe (3)(4)(5)(6)(7)(8)(9)(10)(11) for the last evaluation.…”

Section: Point-of-care Ultrasoundmentioning

confidence: 99%

Surgeon-performed ultrasound for the staging of acute diverticulitis: Preliminary results of a prospective study

Zago

Biloslavo

Mariani

et al. 2021

J Trauma Acute Care Surg

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“…Abdominal cross sectional imaging has been reported to be a useful diagnostic tool in defining duodenal pathology and overcoming the difficulties of clinical and ultrasound examinations. CT is the modality of choice for diverticulitis with a high sensitivity and specificity [ 8 ]. The CT appearance of a duodenal diverticulum includes a saccular outpouching, which may resemble a mass-like structure interposed between the duodenum and the pancreas that contains air, an air-fluid level, fluid, contrast material, or debris [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Duodenal Diverticulosis as an Unusual Cause of Severe Abdominal Pain

Aljabri

Hasosah

Almehdar

et al. 2020

Cureus

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Duodenal diverticulosis (DD) is a rare disease in children, and its etiology is unknown. Here, we report a 13year-old boy with severe abdominal pain. A diagnosis of DD was made based on clinical and image findings. He responds to analgesic, antibiotic and nutritional treatment. The early identification of child with DD as potential cause of severe abdominal pain with pancreatitis is important-because delayed diagnosis might lead to irreversible consequences-to avoid morbidity and mortality, and unnecessary surgery.

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“…This is corroborated in previous publications that demonstrated that definitive diagnosis of diverticulitis in the absence of exploratory laparotomy would be through imaging studies [2] , [4] , [12] . In the past, RCD was diagnosed through the use of contrast enema; however, presently CT and ultrasonography (US) are the imaging modalities of choice due to their high specificity and sensitivity [4] , [14] . In cases of distinguishing RCD, specifically in the cecal region, from acute appendicitis, CT performed with 98% sensitivity and specificity [5] , [7] .…”

Section: Discussionmentioning

confidence: 99%

Perforated cecal diverticulitis with CT diagnosis and medical management

Tsetse

Chaudhry

Jabi

et al. 2019

Radiology Case Reports

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Acute diverticulitis is a painful condition of the gastrointestinal tract that results from sudden inflammation of one or more diverticula in the bowel wall. Right-sided acute diverticulitis, such as cecal diverticulitis, is uncommon diagnosis that can be easily misdiagnosed as acute appendicitis as it shares similar clinical presentation. An unusual complication of right-sided acute diverticulitis such as perforated cecal diverticulitis has different management from acute appendicitis. Thus, definitive diagnosis of this clinical condition with imaging is crucial to optimal management. We report a case of 43-year-old man who presented to the Emergency Department with acute onset severe right lower quadrant abdominal pain associated with anorexia, fever, and nausea. Computed tomography scans obtained showed findings consistent with perforated diverticulitis limited to the cecum, and normal caliber appendix. Conservative medical treatment was decided based on localized imaging findings with excellent outcome.

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Ultrasound diagnosis of diverticulitis

Cited by 12 publications

References 14 publications

Surgeon-performed ultrasound for the staging of acute diverticulitis: Preliminary results of a prospective study

Surgeon-performed ultrasound for the staging of acute diverticulitis: Preliminary results of a prospective study

Duodenal Diverticulosis as an Unusual Cause of Severe Abdominal Pain

Perforated cecal diverticulitis with CT diagnosis and medical management

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