Possibilities of CT in the diagnosis of complications of intestinal diverticulosis (clinical observation)
Purpose. To determine the possibility of MSCT in the detection and diagnosis of complications of diverticulosis. Materials and methods. MSCT was performed in the apparatus Aqullion Toshiba 64 with collimation of 0.5-1 mm with the multiphase contrast-enhanced and further multiplanar reformatting. The results of MSCT of abdominal organs in 2082 (100%) patients for 2016-2018 in GBUZ GKB im were analyzed. M.E. Zhadkevich, 841 (40%) - for emergency indications. Results. Intestinal diverticula was detected in 239 (11%) patients. CT-signs of diverticulitis were found in 36 (1.7%) subjects: 19 (0.9%) women aged 54 years to 91 years and 17 (0.8%) men aged 27 to 88 years. When admitted to the hospital, all patients (36 people - 100%) with CT signs of diverticulitis complained of severe abdominal pain: with localization in the left iliac and suprapubic areas of 22 (61%) patients, 2 (5.5%) - in the right iliac and suprapubic areas, the remaining 12 (33.5%) patients complained of abdominal pain without a clear localization. Localization of diverticulitis in the sigmoid colon occurred in 22 (61%) cases, in the descending part of the colon - in 13 (36%). In 1 (3%) observation diverticulitis was detected in the terminal part of the jejunum. The presence of perianth infiltrate took place - in 16 (44%) cases, with signs of abscedding - in 4 (11%), peritonitis was observed in 2 (5.5%) examined in combination with signs of intestinal obstruction. Perforation with the presence of a large amount of free gas was detected in 1 (3%) case, microperforation - in 12 (33.5%). A small amount of free fluid in the abdominal cavity was found in 18 (50%) patients. Conclusion. Timely diagnosis of complicated diverticular disease is crucial. MSCT has high sensitivity and specificity in the diagnosis of phlegmon and abscesses of the abdominal cavity, perforation of the intestinal wall, peritonitis, bleeding and intestinal obstruction.