[Prognostic value of the presence of pericolic air bubbles detected by computed tomography in acute diverticulitis]

Cir Cir. 2017 Nov-Dec;85(6):471-477. doi: 10.1016/j.circir.2016.10.024. Epub 2016 Dec 9.
[Article in Spanish]

Abstract

Background: Diverticular disease is common in industrialized countries. Computed tomography has been used as the preferred diagnostic method; although different scales haves been described to classify the disease, none of them encompass total disease aspects and behaviour.

Objetive: To analyze the patients with acute diverticulitis confirmed by computed tomography at the ABC Medical Center Campus Observatorio from January 1, 2010 to December 31, 2012, in whom pericolic free air in the form of bubbles was identified by computed tomography and if this finding can be considered as a prognostic factor for the disease.

Methods: A series of 124 patients was analyzed who had acute diverticulitis confirmed by computed tomography, in order to identify the presence of pericolic bubbles.

Results: Of the 124 patients, 29 presented with pericolic bubbles detected by computed tomography; of these, 62.1% had localized peritoneal signs at the time of the initial assessment, (P<.001); leukocytosis (13.33 vs 11.16, P<.001) and band count (0.97 vs 0.48, P<.001) was higher in this group. Patients with pericolonic bubbles had a longer hospital stay (5.5days vs 4.3days, P<.001) and started and tolerated liquids later (4.24days vs. 3.02days, P<.001) than the group of patients without this finding.

Conclusions: The presence of pericolic bubbles in patients with acute diverticulitis can be related to a more aggressive course of the disease.

Keywords: Colonic diverticulitis; Computed tomography; Diverticulitis colónica; Intestinal perforations; Perforación intestinal; Tomografía axial computada.

Publication types

  • Observational Study

MeSH terms

  • Acute Disease
  • Aged
  • Air*
  • Conservative Treatment
  • Diverticulitis, Colonic / complications
  • Diverticulitis, Colonic / diagnostic imaging*
  • Diverticulitis, Colonic / surgery
  • Diverticulitis, Colonic / therapy
  • Enteral Nutrition
  • Female
  • Humans
  • Length of Stay / statistics & numerical data
  • Leukocytosis / etiology
  • Male
  • Middle Aged
  • Peritoneal Cavity / diagnostic imaging
  • Peritonitis / diagnosis
  • Peritonitis / etiology
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index
  • Tomography, X-Ray Computed*