Statement of the Section Internal Medicine of the DEGUM – Ultrasound Obtains Pole Position for Clinical Imaging in Acute Diverticulitis

doi:10.1055/s-0034-1369761

Ultraschall in der Medizin - European Journal of Ultrasound, Table of Contents

Ultraschall Med 2015; 36(02): 191-195
DOI: 10.1055/s-0034-1369761

DEGUM-Mitteilungen

Georg Thieme Verlag KG Stuttgart · New York

Statement of the Section Internal Medicine of the DEGUM – Ultrasound Obtains Pole Position for Clinical Imaging in Acute Diverticulitis

On the background of the German Guideline Diverticular Disease / Diverticulitis.

Abstract

This paper reviews and interprets the role of ultrasonography in view of the recently published Guideline on diverticular disease of the Consensus conference of the German Societies of Gastroenterology (DGVS) and Visceral Surgery (DGAV) implying a new classification of diverticular disease (CDD). Qualified US is not only equipotent to qualified CT and frequently effectual for diagnosis but considers relevant legislation for radiation exposure protection. Unsurpassed resolution allows detailed resolution thereby allowing to differentiate and stratify the relevant types of diverticular disease. Subsequently, US is considered the first choice of imaging in diverticular disease. Vice versa, CT has definite indications in unclear / discrepant situations – or insufficient US-performance.

Key words

Diverticulitis - diverticular disease - intestinal ultrasonography - ultrasound

Full Text

References

References
1 Leifeld L, Germer CT, Böhm S, Dumoulin FL, Häuser W, Kreis M, Labenz J, Lembcke B, Post S, Reinshagen M, Ritz J-P, Sauerbruch T, Wedel T, von Rahden B, Kruis W. S2k-Leitlinie Divertikelkrankheit/Divertikulitis. S2k Guidelines Diverticular Disease/Diverticulitis. Z Gastroenterol 2014; 52: 663-710
2 Federmann G. Sonographie in der Diagnostik der akuten Colondivertikulitis. Chirurg 1989; 60: 43-46
3 Wilson ASR, Toi A. The value of sonography in the diagnosis of acute diverticulitis of the colon. AJR 1990; 154: 1199-1202
4 Schwerk WB, Schwarz S, Rothmund M. Sonography in Acute Colonic Diverticulitis. Dis Colon Rectum 1992; 35: 1077-1084
5 Pradel JA, Adell JF, Taourel P, Djafari M, Monnin-Delhom E, Bruel JM. Acute colonic diverticulitis: prospective comparative evaluation with US and CT. Radiology 1997; 205: 503-512
6 Kori T, Nemoto M, Maeda M, Tsuzuki Y, Ando T, Sekihara M, Uchida N, Mochida Y, Kogure K, Kuwano H. Sonographic Features of Acute Colonic Diverticulitis: The “Dome Sign”. J Clin Ultrasound 2000; 28: 340-346
7 Hollerweger A, Macheiner P, Rettenbacher T, Brunner W, Gritzmann N. Colonic diverticulitis: diagnostic value and appearance of inflamed diverticula – sonographic evaluation. Eur Radiol 2001; 11: 1956-1963
8 Ripolles T, Agramunt M, Martinez MJ, Costa S, Gomez-Abril SA, Richart J. The role of ultrasound in the diagnosis, management and evolution prognosis of acute left-sided colonic diverticulitis: a review of 208 patients. Eur. Radiol 2003; 13: 2587-2595
9 Farag Soliman M, Wüstner M, Sturm J, Werner A, Diehl SJ, Düber C, Post S. Primärdiagnostik der akuten Sigmadivertikulitis. Sonographie versus Computertomographie, eine prospektive Studie. Ultraschall in Med 2004; 25: 342-347
10 Hughes ES, Cuthbertson AM, Carden AB. The surgical management of acute diverticulitis. Med J Aust 1963; 50 (1) 780-782
11 Hinchey EJ, Schaal PG, Richards GK. Treatment of perforated diverticular disease of the colon. Adv Surg 1978; 12: 85-109
12 Sher ME, Agachan F, Bortul M et al. Laparoscopic surgery for diverticulitis. Surg Endosc 1997; 11: 264-267
13 Wasvary H, Turfah F, Kadro O et al. Same hospitalization resection for acute diverticulitis. Am Surg 1999; 65: 632-635
14 Hansen O, Stock W. Prophylaktische Operation bei der Divertikelkrankheit des Kolons – Stufenkonzept durch exakte Stadieneinteilung. Langenbecks Arch Surg 1999; suppl II 1257-1260
15 Neff CC, van Sonnenberg E. CT of diverticulitis: diagnosis and treatment. Radiol Clin North Am 1989; 27: 743-752
16 Siewert JR, Huber FT, Brune IB. Early elective surgery of acute diverticulitis of the colon. Chirurg 1995; 66: 1182-1189
17 Ambrosetti P, Becker C, Terrier F. Colonic diverticulitis: impact of imaging on surgical management—a prospective study of 542 patients. Eur Radiol 2002; 12: 1145-1149
18 Tursi A, Brandimarte G, Giorgetti G, Elisei W, Maiorano M, Aiello F. The clinical picture of uncomplicated versus complicated diverticulitis of the colon. Dig Dis Sci 2008; 53: 2474-2479
19 Klarenbeek BR, deKorte N, van der Peet DL, Cuesta MA. Review of current classifications for diverticular disease and a translation into clinical practice. Int J Colorectal Dis 2012; 27: 207-214
20 Stollman N, Raskin JB. Diverticular disease of the colon. Lancet 2004; 363: 631-639
21 Whiteway J, Morson BC. Elastosis in diverticular disease of the sigmoid colon. Gut 1985; 26: 258-266
22 Hellwig I, Bottner M, Barrenschee M, Harde J, Egberts JH, Becker T, Wedel T. Alterations of the enteric smooth musculature in diverticular disease. J Gastroenterol 2014; 49 (8) 1241-1252
23 Wedel T, Barrenschee M, Lange Chr, Cossais F, Böttner M. The Morphologic Basis for Developing Diverticular Disease, Diverticulitis, and Diverticular Bleeding. Viszeralmedizin 2015; (in press)
24 Kircher MF, Rhea JT, Kihiczak D, Novelline RA. Frequency, Sensitivity, and Specificity of Individual Signs of Diverticulitis on Thin-Section Helical CT with Colonic Contrast Material: Experience with 312 Cases. AJR 2002; 178: 1313-1318
25 Ricciardi R, Roberts PL, Read TE et al. Cyclical increase in diverticulitis during the summer months. Arch. Surg 2011; 146: 319-323
26 De Korte N, Kuyvenhoven JPh, van der Peet DL, Felt-Bersma RJ, Cuesta MA, Stockmann HBAC. Mild colonic diverticulitis can be treated without antibiotics. A case-control study. Colorectal Disease 2011; 14: 325-330
27 Chabok A, Pâhlman L, Hjern F, Haapaniemi S, Smedh K. AVOD Study Group. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Br J Surg 2012; 99: 532-539
28 Horgan AF, McConnell EJ, Wolff BG, The S, Paterson C. Atypical diverticular disease: surgical results. Dis Colon Rectum 2001; 44: 1315-1318
29 Lembcke B. Diagnosis, differential diagnosis, and classification of diverticular disease. Viszeralmedizin 2015; in press (DOI: 10.1159/000380833)
30 Eglington T, Nguyer T, Raniga S, Dixon L, Dobbs B, Frizelle FA. Patterns of recurrence in patients with acute diverticulitis. Br J Surg 2010; 97: 952-957
31 Chapman J, Davies M, Wolff B. Complicated diverticulitis: is it time to rethink the rules?. Ann Surg 2005; 242: 576-583
32 Parks TG. Natural history of diverticular disease of the colon. A review of 521 cases. Br Med J 1969; 4: 639-642
33 Seitz K. Sonographische Divertikulitisdiagnostik: Der mühsame Weg zur Akzeptanz. Ultraschall in Med 2004; 25: 335-336
34 van Randen A, Laméris W, Wouter van Es H, van Heesewijk HPM, van Ramshorst B, ten Hove W, Bouma WH, van Leeuwen MS, vam Keulen EM, Bossuyt PM, Stoker J, Boermeester MA. on behalf of the OPTIMA study group. A comparison of the Accuracy of Ultrasound and Computed Tomography in common diagnoses causing acute abdominal pain. Eur Radiol 2011; 21: 1535-1545
35 Hertzberg BS, Kliewer MA, Bowie JD, Carroll BA, DeLong DH, Gray L, Nelson RC. Physician training requirements in sonography: how many cases are needed for competence?. AJR 2000; 174: 1221-1227
36 Zielke A, Hasse C, Nies C, Kisker O, Voss M, Sitter H, Rothmund M. Prospective evaluation of ultrasonography in acute colonic diverticulitis. Br J Surg 1997; 84: 385-388
37 Toorenvliet BR, Bakker RFR, Breslau PJ, Merkus JWS, Hamming JF. Colonic diverticulitis: a prospective analysis of diagnostic accuracy and clinical decision-making. Colorectal Diseases 2010; 12: 179-187
38 Laméris W, van Randen A, van Gulik TM, Busch OR, Winkelhagen J, Bossuyt PM, Stoher J, Boermeester MA. A Clinical Decision Rule to Establish the Diagnosis of Acute Diverticulitis at the Emergency Department. Dis Colon Rectum 2010; 53: 896-904
39 Laurell A, Hansson L-E, Gunnarsson U. Acute diverticulitis – clinical presentation and differential diagnostics. Colorectal Diseases 2007; 9: 496-502
40 OʼConnor ES, Smith MA, Heise CP. Outpatient diverticulitis: mild or myth?. J Gastrointest Surg 2012; 16: 1389-1396
41 Liljegren G, Chabok A, Wickbom M, Smedh K, Nilsson K. Acute colonic diverticulitis: a systematic review of diagnostic accuracy. Colorectal Dis 2007; 9: 480-488
42 Mauch M, Seitz KH. Divertikulitis. CME Fortbildung/Continuing Education. Ultraschall in Med 2007; 28: 346-371
43 Puylaert JBCM. Ultrasound of Colon Diverticulitis. Dig Dis 2012; 30: 56-59