The limited role of ultrasound in the diagnostic process of colonic diverticulitis

World J Surg. 2014 Jul;38(7):1814-8. doi: 10.1007/s00268-013-2423-9.

Abstract

Background: Diverticulitis is commonly diagnosed using ultrasound (US), followed by computed tomography (CT). Our aim was to determine the diagnostic accuracy of US compared with CT for patients with uncomplicated and complicated diverticulitis.

Methods: We reviewed medical records of 232 patients admitted with diverticulitis via the emergency department between January 2009 and January 2011. Patients who had undergone US and a CT scan were identified and further analyzed.

Results: A total of 123 patients underwent an US and a CT scan. In 78/94 patients with uncomplicated diverticulitis, results of US and CT scan were compatible (83 %); in 6 of the remaining 29 patients both modalities showed a complicated diverticulitis (21 %). US misdiagnosed 17 % of patients with uncomplicated diverticulitis and 79 % with complicated diverticulitis.

Conclusions: US is insufficient for diagnosing a complicated diverticulitis. Missing a complicated diverticulitis can have important clinical implications, and if diverticulitis is suspected, we suggest obtaining a CT scan to confirm diagnosis and to exclude complications.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Diagnostic Errors*
  • Diverticulitis, Colonic / complications
  • Diverticulitis, Colonic / diagnostic imaging*
  • False Negative Reactions
  • False Positive Reactions
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Ultrasonography