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Diverticulitis
Atif Zaheer, MD; Gabriela Gayer, MD; Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Intramural and pericolonic infectious/inflammatory process resulting from perforation of colonic diverticula

            IMAGING

            • General Features

              • Fluoroscopic Findings

                • CT Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Peery AF et al: AGA clinical practice update on medical management of colonic diverticulitis: expert review. Gastroenterology. 160(3):906-11.e1, 2021
                                      2. Arnold MH: The management of diverticulitis: a review of the guidelines. Med J Aust. 212(9):434-434.e1, 2020
                                      3. Díaz JJT et al: Efficacy of colonoscopy after an episode of acute diverticulitis and risk of colorectal cancer. Ann Gastroenterol. 33(1):68-72, 2020
                                      4. Mendez-Pastor A et al: Complicated diverticulitis. Dis Colon Rectum. 63(1):26-8, 2020
                                      5. Pereira F et al: A selective approach for colonoscopy after acute diverticulitis. Ann Gastroenterol. 33(2):222, 2020
                                      6. Shin D et al: Imaging of gastrointestinal tract perforation. Radiol Clin North Am. 58(1):19-44, 2020
                                      7. Singh S et al: Differentiating colorectal carcinoma from diverticulitis with computerised tomography: does every patient need follow-up colonoscopy after an episode of acute diverticulitis? Cureus. 12(12):e12027, 2020
                                      8. Tau N et al: Free abdominal gas on computed tomography in the emergency department: aetiologies and association between amount of free gas and mortality. Ann R Coll Surg Engl. 1-9, 2020
                                      9. Turner GA et al: Influence of obesity on the risk of recurrent acute diverticulitis. ANZ J Surg. 90(10):2032-5, 2020
                                      10. Dirks K et al: EFSUMB Position Paper: recommendations for gastrointestinal ultrasound (GIUS) in acute appendicitis and diverticulitis. Ultraschall Med. 40(2):163-75, 2019
                                      11. Expert Panel on Gastrointestinal Imaging:. et al: ACR Appropriateness Criteria® left lower quadrant pain-suspected diverticulitis. J Am Coll Radiol. 16(5S):S141-9, 2019
                                      12. O'Donohoe N et al: Follow up colonoscopy may be omissible in uncomplicated left-sided acute diverticulitis diagnosed with CT- a retrospective cohort study. Sci Rep. 9(1):20127, 2019
                                      13. Studniarek A et al: Findings on colonoscopy after diverticulitis: a multicenter review. Am Surg. 85(12):1381-5, 2019
                                      14. Cohan JN: Uncomplicated sigmoid diverticulitis. Dis Colon Rectum. 61(10):1141-4, 2018
                                      15. van Dijk ST et al: A systematic review of pericolic extraluminal air in left-sided acute colonic diverticulitis. Surg Infect (Larchmt). 19(4):362-8, 2018
                                      16. Young-Fadok TM: Diverticulitis. N Engl J Med. 379(17):1635-42, 2018
                                      17. Andrade P et al: Routine colonoscopy after acute uncomplicated diverticulitis - challenging a putative indication. Dig Surg. 34(3):197-202, 2017
                                      18. van Dijk ST et al: Predictive factors on CT imaging for progression of uncomplicated into complicated acute diverticulitis. Int J Colorectal Dis. 32(12):1693-8, 2017
                                      19. Ambrosetti P: Acute left-sided colonic diverticulitis: clinical expressions, therapeutic insights, and role of computed tomography. Clin Exp Gastroenterol. 9:249-57, 2016
                                      20. Horesh N et al: Diverticulitis: does age matter? J Dig Dis. 17(5):313-8, 2016
                                      21. Sessa B et al: Acute perforated diverticulitis: assessment with multidetector computed tomography. Semin Ultrasound CT MR. 37(1):37-48, 2016
                                      22. Jackson JD et al: Systematic review: outpatient management of acute uncomplicated diverticulitis. Int J Colorectal Dis. 29(7):775-81, 2014
                                      23. Sallinen VJ et al: Nonoperative management of perforated diverticulitis with extraluminal air is safe and effective in selected patients. Dis Colon Rectum. 57(7):875-81, 2014
                                      24. Ames JT et al: Septic thrombophlebitis of the portal venous system: clinical and imaging findings in thirty-three patients. Dig Dis Sci. 56(7):2179-84, 2011
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Definitions

                                                  • Intramural and pericolonic infectious/inflammatory process resulting from perforation of colonic diverticula

                                                IMAGING

                                                • General Features

                                                  • Fluoroscopic Findings

                                                    • CT Findings

                                                      • Ultrasonographic Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Microscopic Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Peery AF et al: AGA clinical practice update on medical management of colonic diverticulitis: expert review. Gastroenterology. 160(3):906-11.e1, 2021
                                                                          2. Arnold MH: The management of diverticulitis: a review of the guidelines. Med J Aust. 212(9):434-434.e1, 2020
                                                                          3. Díaz JJT et al: Efficacy of colonoscopy after an episode of acute diverticulitis and risk of colorectal cancer. Ann Gastroenterol. 33(1):68-72, 2020
                                                                          4. Mendez-Pastor A et al: Complicated diverticulitis. Dis Colon Rectum. 63(1):26-8, 2020
                                                                          5. Pereira F et al: A selective approach for colonoscopy after acute diverticulitis. Ann Gastroenterol. 33(2):222, 2020
                                                                          6. Shin D et al: Imaging of gastrointestinal tract perforation. Radiol Clin North Am. 58(1):19-44, 2020
                                                                          7. Singh S et al: Differentiating colorectal carcinoma from diverticulitis with computerised tomography: does every patient need follow-up colonoscopy after an episode of acute diverticulitis? Cureus. 12(12):e12027, 2020
                                                                          8. Tau N et al: Free abdominal gas on computed tomography in the emergency department: aetiologies and association between amount of free gas and mortality. Ann R Coll Surg Engl. 1-9, 2020
                                                                          9. Turner GA et al: Influence of obesity on the risk of recurrent acute diverticulitis. ANZ J Surg. 90(10):2032-5, 2020
                                                                          10. Dirks K et al: EFSUMB Position Paper: recommendations for gastrointestinal ultrasound (GIUS) in acute appendicitis and diverticulitis. Ultraschall Med. 40(2):163-75, 2019
                                                                          11. Expert Panel on Gastrointestinal Imaging:. et al: ACR Appropriateness Criteria® left lower quadrant pain-suspected diverticulitis. J Am Coll Radiol. 16(5S):S141-9, 2019
                                                                          12. O'Donohoe N et al: Follow up colonoscopy may be omissible in uncomplicated left-sided acute diverticulitis diagnosed with CT- a retrospective cohort study. Sci Rep. 9(1):20127, 2019
                                                                          13. Studniarek A et al: Findings on colonoscopy after diverticulitis: a multicenter review. Am Surg. 85(12):1381-5, 2019
                                                                          14. Cohan JN: Uncomplicated sigmoid diverticulitis. Dis Colon Rectum. 61(10):1141-4, 2018
                                                                          15. van Dijk ST et al: A systematic review of pericolic extraluminal air in left-sided acute colonic diverticulitis. Surg Infect (Larchmt). 19(4):362-8, 2018
                                                                          16. Young-Fadok TM: Diverticulitis. N Engl J Med. 379(17):1635-42, 2018
                                                                          17. Andrade P et al: Routine colonoscopy after acute uncomplicated diverticulitis - challenging a putative indication. Dig Surg. 34(3):197-202, 2017
                                                                          18. van Dijk ST et al: Predictive factors on CT imaging for progression of uncomplicated into complicated acute diverticulitis. Int J Colorectal Dis. 32(12):1693-8, 2017
                                                                          19. Ambrosetti P: Acute left-sided colonic diverticulitis: clinical expressions, therapeutic insights, and role of computed tomography. Clin Exp Gastroenterol. 9:249-57, 2016
                                                                          20. Horesh N et al: Diverticulitis: does age matter? J Dig Dis. 17(5):313-8, 2016
                                                                          21. Sessa B et al: Acute perforated diverticulitis: assessment with multidetector computed tomography. Semin Ultrasound CT MR. 37(1):37-48, 2016
                                                                          22. Jackson JD et al: Systematic review: outpatient management of acute uncomplicated diverticulitis. Int J Colorectal Dis. 29(7):775-81, 2014
                                                                          23. Sallinen VJ et al: Nonoperative management of perforated diverticulitis with extraluminal air is safe and effective in selected patients. Dis Colon Rectum. 57(7):875-81, 2014
                                                                          24. Ames JT et al: Septic thrombophlebitis of the portal venous system: clinical and imaging findings in thirty-three patients. Dig Dis Sci. 56(7):2179-84, 2011