Predictive factors on CT imaging for progression of uncomplicated into complicated acute diverticulitis

International Journal of Colorectal Disease
S T van DijkM A Boermeester

Abstract

Since outpatient treatment and omitting antibiotics for uncomplicated acute colonic diverticulitis have been proven to be safe in the majority of patients, selection of patients that may not be suited for this treatment strategy becomes an important topic. The aim of this study is to identify computed tomography (CT) imaging predictors for a complicated disease course of initially uncomplicated acute diverticulitis. CT imaging from a randomized controlled trial (DIABOLO study) of an observational vs. antibiotic treatment strategy of first-episode uncomplicated acute diverticulitis patients was re-evaluated. For each patient that developed complicated diverticulitis within 90 days after randomization, two patients with an uncomplicated disease course were randomly selected. Two abdominal radiologists, blinded for outcomes, independently re-evaluated all CTs. Of the 528 patients in the DIABOLO trial, 16 patients developed complications (abscess > 5 cm, perforation, bowel obstruction) within 90 days after randomization. In the group with a complicated course of initially uncomplicated diverticulitis, more patients with fluid collections (25 vs. 0%; p = 0.009) and a longer inflamed colon segment (86 ± 26 mm vs. 65 ± 21 mm; p = 0.00...Continue Reading

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Citations

Nov 6, 2018·Scandinavian Journal of Gastroenterology·Hendrike E BolkensteinWerner A Draaisma
Apr 2, 2019·Surgical Infections·Simone J RottierMarja A Boermeester
Sep 28, 2020·Digestive Diseases and Sciences·Augusto LauroValeria Tonini
Mar 29, 2020·Nature Reviews. Disease Primers·Antonio TursiSilvio Danese
Mar 18, 2021·World Journal of Gastroenterology : WJG·Mark H Hanna, Andreas M Kaiser
Mar 26, 2021·BMJ : British Medical Journal·Anne F Peery
Jul 28, 2020·European Journal of Radiology·Cécile VerheydenPatrice Taourel
Jan 18, 2022·Annals of Internal Medicine·Amir QaseemUNKNOWN Clinical Guidelines Committee of the American College of Physicians*

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