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CT imaging for prediction of complications and recurrence in acute uncomplicated diverticulitis
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Colorectal Surgery.
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2016 (English)In: International Journal of Colorectal Disease, ISSN 0179-1958, E-ISSN 1432-1262, Vol. 31, no 2, 451-457 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2016. Vol. 31, no 2, 451-457 p.
Keyword [en]
Colonic diverticulitis; Complications; CT scan; Prediction
National Category
Gastroenterology and Hepatology Surgery
Identifiers
URN: urn:nbn:se:uu:diva-269592DOI: 10.1007/s00384-015-2423-3ISI: 000369537500034PubMedID: 26490053OAI: oai:DiVA.org:uu-269592DiVA: diva2:883429
Available from: 2015-12-17 Created: 2015-12-17 Last updated: 2017-12-01Bibliographically approved

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Thorisson, ArnarSmedh, KennetPåhlman, LarsChabok, Abbas

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Centre for Clinical Research, County of VästmanlandColorectal Surgery
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