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Titolo:
Sonography of acute right side colonic diverticulitis
Autore:
Chou, YH; Chiou, HJ; Tiu, CM; Chen, JD; Hsu, CC; Lee, CH; Liu, WY; Hung, GS; Yu, C;
Indirizzi:
Vet Gen Hosp, Dept Radiol, Taipei, Taiwan Vet Gen Hosp Taipei TaiwanVet Gen Hosp, Dept Radiol, Taipei, Taiwan Natl Yang Ming Univ, Sch Med, Taipei 112, Taiwan Natl Yang Ming Univ Taipei Taiwan 112 Univ, Sch Med, Taipei 112, Taiwan Vet Gen Hosp, Dept Emergency, Taipei, Taiwan Vet Gen Hosp Taipei TaiwanVet Gen Hosp, Dept Emergency, Taipei, Taiwan Vet Gen Hosp, Dept Surg, Taipei 11217, Taiwan Vet Gen Hosp Taipei Taiwan11217 n Hosp, Dept Surg, Taipei 11217, Taiwan Natl Yang Ming Univ, Inst Biomed Engn, Taipei 112, Taiwan Natl Yang Ming Univ Taipei Taiwan 112 st Biomed Engn, Taipei 112, Taiwan
Titolo Testata:
AMERICAN JOURNAL OF SURGERY
fascicolo: 2, volume: 181, anno: 2001,
pagine: 122 - 127
SICI:
0002-9610(200102)181:2<122:SOARSC>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE APPENDICITIS; DIAGNOSIS; DISEASE; CT; ULTRASONOGRAPHY; APPENDECTOMY; US;
Keywords:
colon; diverticulum; appendicitis; ultrasound; inflammatory bowel disease; acute abdominal pain;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Tiu, CM Vet Gen Hosp, Dept Radiol, Taipei, Taiwan Vet Gen Hosp Taipei Taiwan en Hosp, Dept Radiol, Taipei, Taiwan
Citazione:
Y.H. Chou et al., "Sonography of acute right side colonic diverticulitis", AM J SURG, 181(2), 2001, pp. 122-127

Abstract

Background: To describe the prevalence and sonographic findings and ultrasound diagnostic accuracy of the right side colonic diverticulitis in patients having right lower abdominal pain with indeterminate nature. Methods: A total of 934 patients with acute right lower abdominal pain of clinically indeterminate nature were referred for ultrasound examination (US). US studies were performed with 3.5 to 7.0 (or occasionally 10) MHz transducers using graded compression method. Twenty-three patients were finallydiagnosed to have an uncomplicated acute diverticulitis of the right colon. The gray-scale sonographic images were reviewed. A retrospective study was undertaken to evaluate diagnostic contribution of US. Results: The prevalence of acute right side colonic diverticulitis was 2.5% in patients with clinically indeterminate acute right lower abdominal pain. Locations of the inflamed diverticula include cecum in 6 patients, proximal ascending colon in 15 patients, and distal ascending colon in only 2 patients. Sonography detected 21 inflammed diverticula with 1 false positive and 2 false negative results. The most typical sonographic feature of an inflamed diverticulum of right side colon was a rounded or oval-shaped hypoechoic or nearly anechoic structure (52%) protruding out from the segmentallythickened colonic wall. Some of them might contain strong echoes representing gas or feces (43%). or stone in the lumen (5%). Regional pericolic or peridiverticular fat thickening was noted in 57% of patients, and segmental colon wall thickening in 38%. US examination yielded a sensitivity of 91.3%, a specificity of 99.8%, an overall accuracy of 99.5%, a positive predictive value of 95.5%. and a negative predictive value of 99.7%. A positive sonogram made the likelihood of acute right side diverticulitis 456.5 times greater compared with the pretest clinical impression. US differentiated acute right side colonic diverticulitis from acute appendicitis with a 100% accuracy. Conclusions: Ultrasound can be extremely useful in diagnosing acute right side colonic diverticulitis. Careful ultrasound evaluation of the right colon and the cecum may facilitate a correct diagnosis and help differentiate from acute apprendicitis, and steer the surgeon to a more effective management. (C) 2001 Excerpta Medica, Inc. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/01/20 alle ore 13:13:58