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- Title
Surgical management in acute diverticulitis and its association with multi-detector CT, modified Hinchey classification, and clinical parameters.
- Authors
Bates, David D. B.; Fernandez, Marina Bernal; Ponchiardi, Cecilia; von Plato, Michael; Teich, Joshua P.; Narsule, Chaitan; Anderson, Stephan W.; Gupta, Avneesh; LeBedis, Christina A.
- Abstract
Purpose: To assess whether CT findings, clinical parameters, and modified Hinchey classification are predictive of management outcomes of patients with acute diverticulitis.Materials and methods: Data were accrued between January 2014 and December 2015. A total of 301 adult subjects were identified from radiology reports, of which six who did not met the inclusion criteria were excluded, thus yielding 295 subjects. Subjects were 43.1% (n = 127) male and 56.9% female (n = 168), with mean age 51.9 years (range 18-90). Two independent abdominal radiologists reviewed all scans; imaging features and a modified Hinchey classification were scored. Descriptive statistics compared the relationships between imaging findings, clinical parameters obtained from medical record review, and modified Hinchey classification with management outcomes.Results: CT findings associated with surgical management include the presence of a pericolonic fluid collection (36.8% vs. 8.2%, P = 0.0001), colonic fistula (13.2% vs. 0.4%, P = 0.0002), extraluminal air (26.4% vs. 9.3%, P = 0.0052), bowel obstruction (5.2% vs. 0.0%, P = 0.0162), and a modified Hinchey score of Ib or higher (55.3% vs. 11.7%, P = 0.0001). Slightly lower systolic blood pressure was also associated with operative management (137.2 mmHg vs. 128.2 mmHg, P = 0.0220).Conclusion: Specific CT imaging features and modified Hinchey classification are associated with subsequent surgical management in patients with acute diverticulitis.
- Subjects
DIVERTICULITIS; COMPUTED tomography; DESCRIPTIVE statistics; COLON diseases; ABDOMINAL radiography; THERAPEUTICS
- Publication
Abdominal Radiology, 2018, Vol 43, Issue 8, p2060
- ISSN
2366-004X
- Publication type
Article
- DOI
10.1007/s00261-017-1422-y