Abstract
AIM: to evaluate the role of computed tomography (CT) in the treatment and diagnostic algorithm in patients with complicated diverticular disease (CDD).PATIENTS AND METHODS: during the period from 2014 to 2020, 165 hospitalized patients with complications of CDD included in the study. Fifteen (9.1%) patients were hospitalized for elective indications and 150 (90.9%) as emergencies. The indications for hospitalization were inflammatory complications of CDD. Computed tomography with intravenous contrast was performed in 89 (53.9%) patients. The study was performed on a 64-slice CT “Philips Brilliance 64” with intravenous bolus injection of a low-osmolar iodine-containing contrast agent. The absence of the CT in the remaining patients is due to the presence of classical symptoms of acute diverticulitis with a previously verified diagnosis of CDD, the presence of an informative transabdominal ultrasound, as well as the refusal of patients from CT.RESULTS: the CT allowed to verify the presence of diverticula in the patients, to reveal the distinctive CT signs and pathognomonic symptoms of inflammatory complications of CDD, as well as to establish the severity of the complications that occurred. The specific signs of the destruction of the diverticulum and the complications developed were abdominal mass, abscess, peritonitis, and fistula. Besides the diagnostic value, CT scan permitted to choose the treatment approach and to clarify indications for surgery. Besides that, some CDD complications revealed by CT were considered as a predictor of ineffectiveness of conservative treatment, which requires surgery.CONCLUSION: CT is a valuable diagnostic method for CDD which allows to determine timely the clinical form of inflammatory complication, to find out indications for surgery and to predict high risk of recurrence.
Highlights
ЦЕЛЬ: оценить роль компьютерной томографии в лечебно-диагностическом алгоритме при осложненных формах дивертикулярной болезни ободочной кишки (ДБОК)
The study was performed on a 64-slice computed tomography (CT) “Philips Brilliance 64” with intravenous bolus injection of a low-osmolar iodine-containing contrast agent
The absence of the CT in the remaining patients is due to the presence of classical symptoms of acute diverticulitis with a previously verified diagnosis of complicated diverticular disease (CDD), the presence of an informative transabdominal ultrasound, as well as the refusal of patients from CT
Summary
Карпухин О.Ю.1,2, Юсупова А.Ф.1,2, Панкратова Ю.С.1, Черкашина М.И.2, Ахмадуллина А.А.1. ЦЕЛЬ: оценить роль компьютерной томографии в лечебно-диагностическом алгоритме при осложненных формах дивертикулярной болезни ободочной кишки (ДБОК). ПАЦИЕНТЫ И МЕТОДЫ: в исследование включены 165 пациентов с осложнениями ДБОК, находившиеся на стационарном исследовании в 2014–2020 гг. РЕЗУЛЬТАТЫ: проведенная РКТ диагностика позволила верифицировать наличие дивертикулов у пациентов, выявить характерные РКТ признаки и патогномоничные симптомы воспалительных осложнений ДБОК, а также установить тяжесть возникших осложнений. Некоторые осложнения ДБОК, выявленные в ходе РКТ, можно рассматривать в качестве предиктора неэффективности консервативного лечения, что требует активных действий со стороны хирурга. ЗАКЛЮЧЕНИЕ: РКТ — эффективный метод диагностики ДБОК, позволяющий своевременно установить клинический вариант воспалительного осложнения, определить показания к оперативному лечению и прогнозировать вероятность рецидива. КЛЮЧЕВЫЕ СЛОВА: осложненные формы дивертикулярной болезни ободочной кишки, РКТ-диагностика, предикторы рецидива. Компьютерная томография в диагностике и лечении воспалительных осложнений дивертикулярной болезни ободочной кишки.
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