OBJECTIVE: To evaluate the diagnostic accuracy of clinical evaluation and cross-sectional imaging modalities such as ultrasound and computed tomography for patients with suspected colonic diverticulitis and to determine the value of these examinations in clinical decision-making. METHOD: A prospective analysis was conducted of 802 consecutive patients that presented with abdominal pain at the emergency department. Initial clinical diagnoses and management proposals were compared to the final diagnoses and therapeutic strategies for all patients. RESULTS: Fifty-seven patients were identified with colonic diverticulitis as the final diagnosis. The positive and negative predictive values for the clinical diagnosis of colonic diverticulitis were 0.65 and 0.98 respectively. Additional cross-sectional imaging had a positive and negative predictive value of respectively 0.95 and 0.99 or higher. These additional examinations led to a correct change of the initial clinical diagnosis in 37% of the patients, and a change in management in only 7%. CONCLUSION: The accuracy of the clinical diagnosis for colonic diverticulitis is low. Ultrasound and computed tomography have superior diagnostic accuracy but these examinations rarely change the initial management proposal.
OBJECTIVE: To evaluate the diagnostic accuracy of clinical evaluation and cross-sectional imaging modalities such as ultrasound and computed tomography for patients with suspected colonic diverticulitis and to determine the value of these examinations in clinical decision-making. METHOD: A prospective analysis was conducted of 802 consecutive patients that presented with abdominal pain at the emergency department. Initial clinical diagnoses and management proposals were compared to the final diagnoses and therapeutic strategies for all patients. RESULTS: Fifty-seven patients were identified with colonic diverticulitis as the final diagnosis. The positive and negative predictive values for the clinical diagnosis of colonic diverticulitis were 0.65 and 0.98 respectively. Additional cross-sectional imaging had a positive and negative predictive value of respectively 0.95 and 0.99 or higher. These additional examinations led to a correct change of the initial clinical diagnosis in 37% of the patients, and a change in management in only 7%. CONCLUSION: The accuracy of the clinical diagnosis for colonic diverticulitis is low. Ultrasound and computed tomography have superior diagnostic accuracy but these examinations rarely change the initial management proposal.
Authors: Rosario Cuomo; Giovanni Barbara; Fabio Pace; Vito Annese; Gabrio Bassotti; Gian Andrea Binda; Tino Casetti; Antonio Colecchia; Davide Festi; Roberto Fiocca; Andrea Laghi; Giovanni Maconi; Riccardo Nascimbeni; Carmelo Scarpignato; Vincenzo Villanacci; Bruno Annibale Journal: United European Gastroenterol J Date: 2014-10 Impact factor: 4.623
Authors: G A Binda; R Cuomo; A Laghi; R Nascimbeni; A Serventi; D Bellini; P Gervaz; B Annibale Journal: Tech Coloproctol Date: 2015-09-16 Impact factor: 3.781
Authors: K Nielsen; M C Richir; T T Stolk; T van der Ploeg; G R H M Moormann; B M Wiarda; W H Schreurs Journal: World J Surg Date: 2014-07 Impact factor: 3.352