Acute diverticulitis.
This 55 year old man presented with left iliac fossa pain.
Contrast-enhanced CT shows multiple gas-filled outpouchings from the sigmoid colon, indicating diverticular disease.
There is stranding of the fat around the sigmoid colon (arrow), which indicates an inflammatory process i.e. acute diverticulitis.
An additional role of CT in this setting is the evaluation of potential complications of diverticulitis e.g. perforation, abscess and fistula formation.
There are other diseases with similar symptoms to diverticulitis. Among these are:
- Stomach ulcer
- Pancreatitis – infection, and inflammation of the pancreas
- Cholecystitis – infection, and inflammation of the gallbladder
- Bowel cancer
- Irritable bowel syndrome (IBS)
Diverticulitis is usually diagnosed during an acute attack. Abdominal pain can indicate a number of different problems. So your doctor will need to rule out other causes for your symptoms.
Diverticulitis is commonly noticed and diagnosed during a sudden and painful attack. Pain in the abdomen can mean several diseases. So the doctor’s job is to correctly identify that condition is diverticulitis and not another one.
- When you visit your physician, he will likely examine your abdomen for tenderness and pain. For women, the doctor will want to make sure that what you have is NOT a pelvic (area of the reproductive organs) disease. So he might make an examination inside the vagina and uterus.
- The doctor is expected to do several tests to successfully and accurately identify the disease. These tests will be able to exclude other possible diseases with similar symptoms.
- For women of the right age, a pregnancy test to rule it out as the possible cause of abdominal pain.
- A liver enzyme test could be done to rule out liver disease. This test detects concentrations of certain enzymes in the blood. If the liver is damaged, these will leak into the blood at abnormally high levels. A negative result means normal levels of the enzyme and a normal liver.
- A stool test will rule out infection if you’re having diarrhea. A positive test could indicate diverticulitis.
- Blood tests will check if an infection is happening, which is the case for diverticulitis.
- Colonoscopy – a thin tube with a camera at the end (a colonoscope) is inserted into your rectum and guided into your colon. Before the procedure begins, you will be given a laxative to clear out your bowels. This will enable the doctor to directly see any abnormal condition in the colon.
- A CT scan will enable the doctor to visually see the pouches and if these are inflamed. This test can strongly confirm diverticulitis and even show how severe it is.
