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International Journal of Colorectal Disease

, Volume 31, Issue 2, pp 451–457 | Cite as

CT imaging for prediction of complications and recurrence in acute uncomplicated diverticulitis

  • A. Thorisson
  • K. Smedh
  • M. R. Torkzad
  • L. Påhlman
  • A. Chabok
Original Article

Abstract

Purpose

The first randomized clinical trial of antibiotics in uncomplicated diverticulitis (the AVOD study) showed no benefit of antibiotics. The aim of this study was to re-evaluate the computed tomography (CT) scans of the patients in the AVOD study to find out whether there were CT findings that were missed and to study whether CT signs in uncomplicated diverticulitis could predict complications or recurrence.

Methods

The CT scan images from patients included in the AVOD study were re-evaluated and graded by two independent reviewers for different signs of diverticulitis, including complications, such as extraluminal gas or the presence of an abscess.

Results

Of the 623 patients included in the study, 602 CT scans were obtained and re-evaluated. Forty-four (7 %) patients were found to have complications on the admitting CT scan that had been overlooked. Twenty-seven had extraluminal gas and 17 had an abscess. Four of these patients deteriorated and required surgery, but the remaining patients improved without complications. Of the 18 patients in the no-antibiotic group, in whom signs of complications on CT were overlooked, 15 recovered without antibiotics. No CT findings in patients with uncomplicated diverticulitis could predict complications or recurrence.

Conclusion

No CT findings that could predict complications or recurrence were found. A weakness in the initial assessment of the CT scans to detect extraluminal gas and abscess was found but, despite this, the majority of patients recovered without antibiotics. This further supports the non-antibiotic strategy in uncomplicated diverticulitis.

Keywords

Colonic diverticulitis Complications CT scan Prediction 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • A. Thorisson
    • 1
  • K. Smedh
    • 2
    • 3
  • M. R. Torkzad
    • 4
  • L. Påhlman
    • 5
  • A. Chabok
    • 2
    • 3
  1. 1.Department of RadiologyVästmanland’s Hospital VästeråsVästeråsSweden
  2. 2.Colorectal Unit, Department of SurgeryVästmanland’s Hospital VästeråsVästeråsSweden
  3. 3.Centre for Clinical Research Uppsala UniversityVästmanland’s Hospital VästeråsVästeråsSweden
  4. 4.Department of RadiologyUniversity CollegeLondonUK
  5. 5.Department of Surgical SciencesUppsala UniversityUppsalaSweden

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