[Early use of CT in the management of acute diverticulitis of the colon]. / El uso precoz de la tomografía computarizada en el manejo de la diverticulitis aguda.
Rev Esp Enferm Dig
; 99(6): 320-4, 2007 Jun.
Article
em Es
| MEDLINE
| ID: mdl-17883294
ABSTRACT
OBJECTIVE:
To assess the early use of CT for the diagnosis, staging, and management of acute diverticulitis. MATERIAL ANDMETHODS:
A prospective study of 102 patients with a clinical diagnosis of acute diverticulitis of the left colon. Acute diverticulitis was initially divided into 3 clinical stages. Patients were restaged according to CT findings into stages I, IIa, IIb, and III. Diagnosis was subsequently confirmed intraoperatively or by colonoscopy or barium studies.RESULTS:
102 patients (52 females and 50 males, mean age of 59.4 (SD + 14.96 years)) were included; 84 (82.35%) patients with a clinical diagnosis of acute diverticulitis were confirmed to suffer this disease for a diagnostic error of 17.65% (n=18). Acute diverticulitis was diagnosed by CT in 84.3% (n=86). CT had a sensitivity of 100% and a specificity of 88.9%. CT changed clinical stage for 38% of patients because of understaging in 13% and of overstaging in 25%. When stages II and III were analyzed separately, 60 and 50% were overstaged, respectively. The reclassification of patients according to CT results had a significant impact on treatment.CONCLUSIONS:
Early clinical staging with CT avoids diagnostic clinical errors in 17.65% of patients. CT changes the initial clinical staging of acute episodes in 38% of cases, thus avoiding unnecessary delays in surgery for severe cases, and unnecessary surgeries for mild cases.
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Bases de dados:
MEDLINE
Assunto principal:
Tomografia Computadorizada por Raios X
/
Doença Diverticular do Colo
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
Es
Revista:
Rev Esp Enferm Dig
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2007
Tipo de documento:
Article