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Published in: Journal of Gastrointestinal Surgery 8/2008

01-08-2008 | ssat state of the art

Acute Diverticulitis of the Left Colon: Value of the Initial CT and Timing of Elective Colectomy

Author: Patrick Ambrosetti

Published in: Journal of Gastrointestinal Surgery | Issue 8/2008

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Abstract

Computed Tomography is undeniably the most useful tool to confirm the suspected diagnosis of acute left-colonic diverticulitis and to objectively grade its severity into moderate diverticulitis (no signs of colonic perforation) and severe diverticulitis (signs of colonic perforation). Indeed, the severity of acute diverticulitis is statistically predictive of the risk both to need surgical treatment of the first episode of acute diverticulitis, and to follow a complicated evolution after successful conservative treatment of the acute phase. Consequently, CT brings a major contribution to define the place of surgery during the acute phase of diverticulitis, and, later on, inside the long-term evolution of the disease after initial successful conservative treatment.
Literature
1.
go back to reference Ambrosetti P, Rohner A. De la diverticulose à la diverticulite: vol de nuit? Lyon Chir 1990;86:283–286. Ambrosetti P, Rohner A. De la diverticulose à la diverticulite: vol de nuit? Lyon Chir 1990;86:283–286.
2.
go back to reference Rao PM, Rhea JT, Novelline RA et al. Helical CT with only colonic contrast material for diagnosing diverticulitis: prospective evaluation of 150 patients. Am J Roentgenol 1998;170:1445–1449. Rao PM, Rhea JT, Novelline RA et al. Helical CT with only colonic contrast material for diagnosing diverticulitis: prospective evaluation of 150 patients. Am J Roentgenol 1998;170:1445–1449.
3.
go back to reference Werner A, Diehl SJ, Farag-Soliman N, Düber C. Multi-slice spiral CT in routine diagnosis of suspected left-sided colonic diverticulitis: a prospective study of 120 patients. Eur Radiol 2003;13:2596–2603.PubMedCrossRef Werner A, Diehl SJ, Farag-Soliman N, Düber C. Multi-slice spiral CT in routine diagnosis of suspected left-sided colonic diverticulitis: a prospective study of 120 patients. Eur Radiol 2003;13:2596–2603.PubMedCrossRef
4.
go back to reference Ambrosetti P, Grossholz M, Becker C, Terrier F, Morel Ph. Computed tomography in acute left-colonic diverticulitis. Br J Surg 1997;84:532–534.PubMedCrossRef Ambrosetti P, Grossholz M, Becker C, Terrier F, Morel Ph. Computed tomography in acute left-colonic diverticulitis. Br J Surg 1997;84:532–534.PubMedCrossRef
5.
go back to reference Chautems RC, Ambrosetti P, Ludwig A et al. Long-term follow-up after first acute episode of sigmoid diverticulitis: is surgery mandatory? A prospective study of 118 patients. Dis Colon Rectum 2002;45:962–966.PubMedCrossRef Chautems RC, Ambrosetti P, Ludwig A et al. Long-term follow-up after first acute episode of sigmoid diverticulitis: is surgery mandatory? A prospective study of 118 patients. Dis Colon Rectum 2002;45:962–966.PubMedCrossRef
6.
go back to reference Ambrosetti P, Jenny A, Becker Ch, Terrier F, Morel Ph. Acute left-colonic diverticulitis-Compared performance of computed tomography and water-soluble contrast enema. Dis Colon Rectum 2000;43:1363–1367.PubMedCrossRef Ambrosetti P, Jenny A, Becker Ch, Terrier F, Morel Ph. Acute left-colonic diverticulitis-Compared performance of computed tomography and water-soluble contrast enema. Dis Colon Rectum 2000;43:1363–1367.PubMedCrossRef
7.
go back to reference Ambrosetti P, Becker C, Terrier F. Colonic diverticulitis: impact of imaging on surgical management. A prospective study of 542 patients. Eur Radiol 2002;12:1145–1149.PubMedCrossRef Ambrosetti P, Becker C, Terrier F. Colonic diverticulitis: impact of imaging on surgical management. A prospective study of 542 patients. Eur Radiol 2002;12:1145–1149.PubMedCrossRef
8.
9.
go back to reference Janes S, Meagher A, Frizelle FA. Elective surgery after acute diverticulitis. Br J Surg 2005;92:133–142.PubMedCrossRef Janes S, Meagher A, Frizelle FA. Elective surgery after acute diverticulitis. Br J Surg 2005;92:133–142.PubMedCrossRef
10.
go back to reference Guller U, Jain N, Hervey S, Purves H, Pietrobon R. Laparoscopic vs open colectomy: outcomes comparison based on large nationwise databases. Arch Surg 2003;138:1179–1186.PubMedCrossRef Guller U, Jain N, Hervey S, Purves H, Pietrobon R. Laparoscopic vs open colectomy: outcomes comparison based on large nationwise databases. Arch Surg 2003;138:1179–1186.PubMedCrossRef
11.
go back to reference Wong WD, Wexner SD, Lowry A, et al. Practice parameters for the treatment of sigmoid diverticulitis. The Standards Task Force The American Society of Colon and Rectal Surgeons. Dis Colon Rectum 2000;43:290–297.PubMedCrossRef Wong WD, Wexner SD, Lowry A, et al. Practice parameters for the treatment of sigmoid diverticulitis. The Standards Task Force The American Society of Colon and Rectal Surgeons. Dis Colon Rectum 2000;43:290–297.PubMedCrossRef
12.
go back to reference Stollman NH, Raskin JB. For and on Ad Hoc Practice Parameters Committee of the American College of Gastroenterology. Behalf of the Diagnosis and management of diverticular disease of the colon in adults. Am J Gastroenterol 1999;94:3110–3121.PubMedCrossRef Stollman NH, Raskin JB. For and on Ad Hoc Practice Parameters Committee of the American College of Gastroenterology. Behalf of the Diagnosis and management of diverticular disease of the colon in adults. Am J Gastroenterol 1999;94:3110–3121.PubMedCrossRef
13.
go back to reference Köhler L, Sauerland S, Neugebauer E. for the Scientific Committee of the European Association for Endoscopic Surgery Diagnosis and treatment of diverticular disease. Surg Endosc 1999;13:430–436.PubMedCrossRef Köhler L, Sauerland S, Neugebauer E. for the Scientific Committee of the European Association for Endoscopic Surgery Diagnosis and treatment of diverticular disease. Surg Endosc 1999;13:430–436.PubMedCrossRef
14.
go back to reference Parks TG. Natural history of diverticular disease of the colon. A review of 521 cases. BMJ 1969;4:639–642.PubMedCrossRef Parks TG. Natural history of diverticular disease of the colon. A review of 521 cases. BMJ 1969;4:639–642.PubMedCrossRef
15.
go back to reference Guzzo J, Hyman N. Diverticulitis in young patients: is resection after a single attack always warranted? Dis Colon Rectum 2004;47:1187–1190.PubMedCrossRef Guzzo J, Hyman N. Diverticulitis in young patients: is resection after a single attack always warranted? Dis Colon Rectum 2004;47:1187–1190.PubMedCrossRef
16.
go back to reference Anaya DA, Flum DR. Risk of emergency colectomy and colostomy in patients with diverticular disease. Arch Surg 2005;140:681–685.PubMedCrossRef Anaya DA, Flum DR. Risk of emergency colectomy and colostomy in patients with diverticular disease. Arch Surg 2005;140:681–685.PubMedCrossRef
17.
go back to reference Broderick-Villa G, Burchette RJ, Collins JC, Abbas MA, Haigh PI. Hospitalization for acute diverticulitis does not mandate routine elective colectomy. Arch Surg 2005;140:576–581.PubMedCrossRef Broderick-Villa G, Burchette RJ, Collins JC, Abbas MA, Haigh PI. Hospitalization for acute diverticulitis does not mandate routine elective colectomy. Arch Surg 2005;140:576–581.PubMedCrossRef
18.
go back to reference Richards RJ, Hammitt JK. Timing of prophylactic surgery in prevention of diverticulitis recurrence: a cost-effectiveness analysis. Dig Dis Sci 2002;47:1903–1908.PubMedCrossRef Richards RJ, Hammitt JK. Timing of prophylactic surgery in prevention of diverticulitis recurrence: a cost-effectiveness analysis. Dig Dis Sci 2002;47:1903–1908.PubMedCrossRef
19.
go back to reference Salem L, Veenstra DL, Sullivan SD, Flum DR. The timing of elective colectomy in diverticulitis: a decision analysis. J Am Coll Surg 2004;199:904–912.PubMedCrossRef Salem L, Veenstra DL, Sullivan SD, Flum DR. The timing of elective colectomy in diverticulitis: a decision analysis. J Am Coll Surg 2004;199:904–912.PubMedCrossRef
20.
go back to reference Ambrosetti P, Chautems R, Soravia C, Peiris-Waser N, Terrier F. Long-term outcome of mesocolic and pelvic diverticular abscesses: a prospective study of 73 cases. Dis Colon Rectum 2005;48:787–791.PubMedCrossRef Ambrosetti P, Chautems R, Soravia C, Peiris-Waser N, Terrier F. Long-term outcome of mesocolic and pelvic diverticular abscesses: a prospective study of 73 cases. Dis Colon Rectum 2005;48:787–791.PubMedCrossRef
21.
go back to reference Thörn M, Graf W, Stefansson T, Pahlman L. Clinical and functional results after elective colonic resection in 75 consecutive patients with diverticular disease. Am J Surg 2002;183:7–11.PubMedCrossRef Thörn M, Graf W, Stefansson T, Pahlman L. Clinical and functional results after elective colonic resection in 75 consecutive patients with diverticular disease. Am J Surg 2002;183:7–11.PubMedCrossRef
22.
go back to reference Munson KD, Hensien MA, Jacob LN, Robinson AM, Liston WA. Diverticulitis. A comprehensive follow-up. Dis Colon Rectum 1996;39:318–322.PubMedCrossRef Munson KD, Hensien MA, Jacob LN, Robinson AM, Liston WA. Diverticulitis. A comprehensive follow-up. Dis Colon Rectum 1996;39:318–322.PubMedCrossRef
23.
go back to reference Breen RE, Corman ML, Robertson WG, Prager ED. Are we really operating on diverticulitis. Dis Colon Rectum 1986;29:174–179.PubMedCrossRef Breen RE, Corman ML, Robertson WG, Prager ED. Are we really operating on diverticulitis. Dis Colon Rectum 1986;29:174–179.PubMedCrossRef
24.
go back to reference Stevenson ARL, Stitz RW, Lumley J, Fielding GA. Laparoscopically assisted anterior resection for diverticular disease: follow-up of 100 consecutive patients. Ann Surg 1998;227:335–342.PubMedCrossRef Stevenson ARL, Stitz RW, Lumley J, Fielding GA. Laparoscopically assisted anterior resection for diverticular disease: follow-up of 100 consecutive patients. Ann Surg 1998;227:335–342.PubMedCrossRef
Metadata
Title
Acute Diverticulitis of the Left Colon: Value of the Initial CT and Timing of Elective Colectomy
Author
Patrick Ambrosetti
Publication date
01-08-2008
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 8/2008
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-008-0489-8

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