What is the role of CT scanning in the diagnosis of diverticulitis?

Updated: Aug 06, 2019
  • Author: Elie M Ghoulam, MD, MS; Chief Editor: BS Anand, MD  more...
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Answer

Although the diagnosis of diverticulitis can be made on clinical grounds, a computed tomography (CT) scan of the abdomen is considered the best imaging method to confirm the diagnosis. The American College of Radiology (ACR) appropriateness criteria for left lower quadrant pain support this recommendation because of the specificity and sensitivity of CT scans, which allow for the diagnosis of the causes of left lower quadrant pain that resembles diverticulitis. [29]

Note the following:

  • CT scans are preferred over intraluminal examinations (eg, barium enema), because the bulk of the inflammation is extraluminal. CT scans can help clinicians assess disease severity, the presence of complications, and clinical staging. In the acute setting, CT scans are safer than contrast studies. Sensitivity and specificity, especially with helical CT scanning and colonic contrast, can be as high as 97%.

  • Possible CT scan findings include the following: pericolic fat stranding due to inflammation, colonic diverticula, bowel wall thickening, soft-tissue inflammatory masses, phlegmon, and abscesses. Peritonitis, fistula formation, and obstruction can also be assessed. In addition, CT scanning can be used to guide percutaneous drainage of an abscess.


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