Acute colonic diverticulitis in a community-based hospital: CT evaluation in 138 patients

Abstract

The purpose of this research is to retrospectively analyze computed tomography (CT) findings of patients with acute colonic diverticulitis presented to a community-based hospital. During a 1-year period from May 2004 to April 2005, CT scans of 138 patients [mean age 62.3 years (SD 14.9), range 30-100 years] with clinical diagnosis of diverticulitis were analyzed. Of the 138 patients, 136 CT scans were performed with oral and intravenous contrast administration except in two patients who received only oral contrast. Twenty-eight patients (28/138, 20.3%) had diverticulosis, 77 (77/138, 55.8%) had uncomplicated diverticulitis, and 33 (33/138, 23.9%) had complications. Left-sided diverticulitis predominated (137/138, 99.3%). Colonic diverticula were identified in almost every patient (136/138, 98.6%); the majority had moderate colonic wall thickening (82/110, 74.5%) and moderate pericolonic inflammation (65/110, 59.1%). Isolated extraluminal air bubbles (19/33, 57.6%) were the most commonly seen complication, followed by abscess (15/33, 45.5%). Bowel obstruction (2/33, 6.1%) and pylephlebitis (1/33, 3.0%) were less commonly seen but were observed as significant abnormalities. Complicated diverticulitis was less prevalent in this community hospital setting, in contrast with referral medical centers. Common CT findings of diverticulitis included presence of diverticula, moderate wall thickening, and pericolonic inflammation. Isolated air bubbles were the most commonly seen complication followed by abscess.