The aim of our study was to determine whether the use of CT scanning in the assessment of acute diverticulitis can be reduced without a negative effect on outcome. Our series consisted of 93 out of 100 patients with acute diverticulitis admitted to the Emergency Room of our institution in the period from February 2012 to March 2013.The Hinchey classification system was used to stage disease based on findings on ultrasound (US) examination and/or computed tomography (CT) scanning. We compared the patients' Hinchey stage (HS) on admission and 72 hours later. Types of treatment were defined as emergency or delayed intervention (operative approaches (OA); ultrasound-guided percutaneous drainage (UPD), and surgery. The borderline between conservative and surgical management was identified. In patients with a HS = 1b surgical intervention was never required and therefore we believe that US imaging is sufficient and they can be spared the exposure to ionizing radiation associated with CT scans. The skill of the individual operator in US examination was found to be of key importance. As regards CT scanning, we found, in agreement with the literature, that it has greater specificity and sensitivity than US, and is therefore indicated if the patient's condition has deteriorated.
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Cureus
December 2024
General Surgery, Local Health Unit of Alto Minho, Viana do Castelo, PRT.
Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract, arising from incomplete obliteration of the vitelline duct. MD contains all layers of the intestinal wall and often remains asymptomatic. Gastrointestinal bleeding, bowel obstruction, and acute diverticulitis occur in a few cases.
View Article and Find Full Text PDFRadiol Case Rep
March 2025
Department of General Surgery, Trauma and Burns Center, University of Tunis El Manar, Ben Arous, Tunisia.
Meckel's diverticulum, a congenital anomaly of the omphalomesenteric duct, is a rare cause of acute abdomen and poses significant diagnostic challenges due to its variable presentation and complications such as perforation. We present the case of a 19-year-old male with a 24-hour history of right iliac fossa pain progressing to generalized abdominal tenderness. Laboratory results showed leukocytosis and elevated C-reactive protein, while CT imaging suggested pneumoperitoneum and an inflamed Meckel diverticulum.
View Article and Find Full Text PDFJ Clin Med
December 2024
UOC Chirurgia d'Urgenza e del Trauma, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Acute diverticulitis (AD), an inflammatory complication of diverticulosis, affects around 4% of individuals with diverticulosis, with increased incidence in older populations. This study aims to assess the impact of sarcopenia, the age-related loss of muscle mass, on the clinical decision-making and outcomes of patients with AD. A retrospective study was conducted on 237 patients admitted to the Emergency Department (ED) between January 2014 and February 2022.
View Article and Find Full Text PDFDiagnostics (Basel)
December 2024
Diagnostic and Interventional Radiology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
: To evaluate the non-inferiority of non-contrast CT compared to contrast-enhanced CT with both intravenous and rectal contrast application for the diagnosis of acute colonic diverticulitis. : Five readers retrospectively evaluated the non-contrast and contrast-enhanced series of CTs of 205 consecutive patients with clinical suspicion of acute diverticulitis. Two randomized reading sessions, both containing all 205 cases as either contrast-enhanced or non-contrast (1:1) series, were performed with ≥8 weeks washout between them.
View Article and Find Full Text PDFAntibiotics (Basel)
December 2024
Department of Microbiology, "Cantacuzino" Institute, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Antimicrobial resistance is one of the main threats to public health, with multidrug-resistant (MDR) pathogens on the rise across continents. Although treatment guidelines generally recommend antimicrobial therapy for acute complicated diverticulitis, they do not specify treatment pathways according to local or national resistance profiles. There is sparse data regarding specific pathogens involved in Hinchey II-IV patients who undergo surgery.
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