Help
Subscribe


Submit Videos to GastroHep Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Toward an evidence-based approach in diagnosing diverticulitis

The latest issue of the Scandanavian Journal of Gastroenterology evaluates the accuracy of the clinical evaluation and diagnostic modalities for patients with suspected acute colonic diverticulitis.

News image

The lack of pathognomonic findings and the chance of complicated disease have resulted in the widespread use of additional imaging to diagnose acute colonic diverticulitis.

The added value of additional imaging in the diagnostic workup of patients suspected of acute colonic diverticulitis is not well defined.

Dr Caroline Suzanne Andeweg and colleagues systematically reviewed the literature of the accuracy of the clinical evaluation and diagnostic modalities for patients with suspected acute colonic diverticulitis, to come to an evidence-based approach to diagnose acute colonic diverticulitis.

The team performed a systematic review and meta-analysis of studies that reported diagnostic accuracy of the clinical diagnosis and diagnostic modalities in patients with suspected diverticulitis.

Study quality was assessed with the STARD checklist.

Sensitivity of contrast enema studies varied between 80% and 83%
Scandanavian Journal of Gastroenterology

True-positive, true-negative, false-positive, and false-negative findings were extracted and pooled estimates of sensitivity and specificity per diagnostic test were calculated, if applicable.

The research team noted that the overall quality of the studies reporting the diagnostic accuracy of the clinical diagnosis, contrast enema and magnetic resonance imaging (MRI) were moderate to poor and not suitable for meta-analysis.

Sensitivity of the clinical diagnosis varied between 64% and 68%.

Ultrasound (US) and computed tomography (CT) studies were eligible for meta-analysis.

The team found that summary sensitivity estimates for US were 90% versus 95% for CT.

Summary specificity estimates for US were 90% versus 96% for CT.

The researchers found that the sensitivity for MRI was 98% and specificity varied between 70% and 78%.

Sensitivity of contrast enema studies varied between 80% and 83%.

Dr Andeweg's team concludes, "In two-thirds of the patients, the diagnosis of acute colonic diverticulitis can be made based on clinical evaluation alone."

"In one-third of the patients, additional imaging is a necessity to establish the diagnosis."

"US and CT are comparable in diagnosing diverticulitis and superior to other modalities."

"CT has the advantage of higher specificity and the ability to identify alternative diagnoses."

"The role of MRI is not yet clear in diagnosing acute colonic diverticulitis."

"Contrast enema is considered an obsolete imaging technique to diagnose acute colonic diverticulitis based on lower sensitivity and specificity than US and CT."

"A step-up approach with CT performed after an inconclusive or negative US, seems a logical and safe approach for patients suspected of acute colonic diverticulitis."

Scand J Gastroenterol 2014: 49(7): 775-784
15 July 2014

Go to top of page Email this page Email this page to a colleague

 29 August 2015

Advanced search
 28 August 2015 
Statin use and survival in pancreatic cancer
 28 August 2015 
Bacterial endotoxin and NAFLD
 28 August 2015 
Interferon-free regimens for Hep C
 27 August 2015 
HCV in Egypt
 27 August 2015 
Gene expression for hepatocellular carcinoma
 27 August 2015 
Liver abnormalities in celiac disease
 26 August 2015 
Medical management of diverticular disease
 26 August 2015 
Treatment of erosive esophagitis
 26 August 2015 
Dermatological complications of anti-TNF therapy in IBD
 25 August 2015 
Markers for colorectal cancer screening
 25 August 2015 
Long-term PPI use and serum gastrin levels
 25 August 2015 
Treatment for HCV and HIV-1 co-infection
 24 August 2015 
Treatment for HCV and HIV-1 co-infection
 24 August 2015 
Cirrhosis in Hepatitis C patients
 24 August 2015 
Aspirin use and colorectal cancer survival
 21 August 2015 
Activity indexes in ulcerative colitis
 21 August 2015 
Coffee and gallstone disease
 21 August 2015 
Alcoholic cirrhosis in relapse after liver transplant
 20 August 2015 
Cirrhosis in the USA
 20 August 2015 
Mortality causes in liver cirrhosis
 20 August 2015 
Risk of death in IBD
 19 August 2015 
Predicting intestinal surgery in Crohn's disease
 19 August 2015 
Improved screening colonoscopy quality
 19 August 2015 
Sleep positioning device reduces reflux
 18 August 2015 
Health insurance influences HCV screening outcomes
 18 August 2015 
Somatostatin analogues in polycystic liver disease
 18 August 2015 
Global consensus report on H. pylori gastritis
 17 August 2015 
Biomarker of fibrosis stage in NAFLD
 17 August 2015 
Prognostic score for primary biliary cirrhosis
 17 August 2015 
Measuring subjective health in patients with IBS
 14 August 2015 
Factors that influence ulcerative colitis procedure type
 14 August 2015 
H. pylori in African American and Hispanic veterans
 14 August 2015 
Hep E virus in decompensated chronic liver disease
 13 August 2015 
H. pylori in drinking water
 13 August 2015 
Sofosbuvir-regimens in HCV
 13 August 2015 
IBS among Japanese adolescents
 12 August 2015 
Infliximab in patients in IBD
 12 August 2015 
Peritoneal carcinomatosis in colorectal cancer
 12 August 2015 
Predictors of severity of IBD
 11 August 2015 
H. pylori and immune thrombocytopenic purpura
 11 August 2015 
Chemotherapy and intestinal microbiomes
 11 August 2015 
Sexual dysfunction after rectal cancer treatment
 10 August 2015 
Scoring systems to predict alcoholic hepatitis outcomes
 10 August 2015 
Sofosbuvir-based regimens in veterans with HCV
 10 August 2015 
Predicting lymph node metastasis in T1 colorectal cancer
 07 August 2015 
Factors associated with changes in ulcerative colitis
 07 August 2015 
Bariatric surgery and NASH in obese patients
 07 August 2015 
Caffeine and fibrosis in Hep C
 06 August 2015 
Disparities in colonoscopic examination
 06 August 2015 
Weight loss and NASH
 06 August 2015 
Diagnosis of IBS
 05 August 2015 
Gender differences in fecal immunochemical tests
 05 August 2015 
Adenoma detection rates with a screening colonoscopy program
 05 August 2015 
Extraintestinal manifestations in IBD diagnosis
 04 August 2015 
IBD environmental risk factors
 04 August 2015 
Measuring disease activity in Crohn's
 04 August 2015 
Gastric emptying and hyperglycemia in diabetes
 03 August 2015 
Vaccinations and IBD
 03 August 2015 
Lack of response to therapy in severe ulcerative colitis
 03 August 2015 
Nutritional vs biological therapy in Crohn's

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us