Purpose: In acute diverticulitis accurate diagnosis and staging are mandatory to decide on the treatment of the patient. The impact of computed tomography (CT) on the treatment of acute diverticulitis will be discussed.
Material and method: CT is performed after distension of the distal colon by means of positive,water-soluble contrast media to depict intestinal perforation or penetration. Then intravenous contrast material is administered and spiral scanning is repeated to judge enhancement patterns of the abdominal structures/organs especially of the intestinal wall and to diagnose abscess formation. CT-morphologies of different stages of acute diverticulitis will be described.
Results: CT imaging is the only diagnostic method that in case of an acute diverticulitis combines safety with accuracy. On the one hand, it is fast and therefore safe with respect to patient control and on the other hand, it allows accurate staging of the inflammatory process reaching a sensitivity and specificity of up to 100%, each. CT is an appropriate tool to diagnose acute diverticulitis complicated by abscess formation, intestinal penetration or perforation and therefore has direct impact on the treatment of the patient.
Discussion: If acute diverticulitis is suspected CT is the method of choice for imaging because of its high impact on the choice of therapy and on the management of complications.