DIAGNOSIS OF ACUTE LEFT-SIDED COLONIC DIVERTICULITIS BY 3 RADIOLOGICAL MODALITIES

Purpose. To compare the findings at US, CT and contrast enema (CE) wit h the clinical, biochemical, and surgical findings in patients with su spected acute left-sided colonic diverticulitis (ALCD). Material and M ethods. The study comprised 32 consecutive patients hospitalized with clinically diagnosed ALCD. During the first 3 days of hospitalization, they were examined by US and CT of the pelvis and abdomen, and CE. Re sults. Of the 32 patients, 21 had ALCD according to the combined radio logical, clinical, biochemical and surgical findings. Findings compati ble with ALCD were verified by radiological examination alone in 12 pa tients (4 patients at US, 10 at CT, and 6 at CE). In 9 patients, only diverticula or tethering was found at either CE or CT, and the diagnos es were then supported by clinical and biochemical findings and clinic al follow-up. The most common clinical symptoms and signs associated w ith ALCD were left lower quadrant pain, left-sided tenderness, and fev er. Most patients showed elevations of the white blood-cell count, ery throcyte sedimentation rate, and C-reactive protein, but there was no statistical difference in the stages of severity of ALCD, or between A LCD and other abdominal disorders. Conclusion: Radiological examinatio n is valuable in confirming the diagnosis of ALCD CT was the radiologi cal modality that best demonstrated AI,CD and revealed complications ( e.g. pericolic abscesses) during the course of the illness.