CT DIAGNOSTICS, CLASSIFICATIONS, AND DEVELOPMENT OF A REPORTING TEMPLATE FOR ACUTE DIVERTICULITIS OF THE COLON
Keywords:
diverticulitis; colon; computed tomography; structured report; abscess; fistula; perforation; peritonitisAbstract
Acute colonic diverticulitis (ACD) is the most common complication of diverticular disease and represents an abdominal emergency. The disease encompasses various conditions - from localized inflammation of a diverticulum to fecal peritonitis, which underscores the importance of accurate diagnosis. Contrast-enhanced computed tomography (CT) plays a key role in diagnostics due to its high sensitivity, specificity, accuracy, and inter-observer agreement. CT allows for the exclusion of alternative diagnoses, localization of the inflamed diverticulum, and detection of complications. Radiological findings are divided into signs related to changes in the intestinal wall and extraintestinal changes. Additionally, CT enables staging of the disease; the most commonly used classifications of ACD severity are the modified Hinchey classification and WSES classification. Differential diagnosis includes colorectal carcinoma, appendicitis with epiploic appendagitis, ischemic colitis, appendicitis, infectious enterocolitis, and inflammatory bowel diseases. We propose a structured report template that will help standardize terminology and improve communication between specialists involved in patient care.
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