May 5, 2011

Acute Sigmoid Diverticulitis

Axial CT image demonstrates left colonic wall thickening, pericolonic fat stranding, fascial thickening (arrowheads) and an inflamed diverticulum (arrow).

Facts: Acute Diverticulitis
  • Diverticular disease found in 5-10% of people over the age of 45 years, and 80% by the age of 80
  • Diverticulitis is the most common complication of diverticular disease. It is found in 10-25% of people with diverticular disease at some point.
  • Most common site of diverticulitis = rectosigmoid colon
  • Diagnosis made on a basis of clinical history (pain, fever, diarrhea), examination (abdominal tenderness, palpable mass), lab (elevated inflammatory markers, leucocytosis) and imaging.
  • CT is considered the best imaging method for diagnosing diverticulitis and characterizing its complications
  • CT findings: diverticula, inflamed diverticula, pericolic fat stranding, colonic wall thickening, phlegmon, abscess, extraluminal air
  • Differentiating acute diverticulitis from malignancy can be a problem since many findings overlap. Suspicion for malignancy is high if there are pericolonic lymph nodes and the involved segment is short and eccentric.
Buckley O, Geoghegan T, O'Riordain DS, et al. Computed tomography in the imaging of colonic diverticulitis. Clin Radiol 2004; 59:977-983.

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