How Would You Manage This Patient With Recurrent Diverticulitis?
Authors: Judy W. Nee, Anthony J. Lembo
Journal: Annals of Internal Medicine (2024)

LettersJanuary 2024How Would You Manage This Patient With Recurrent Diverticulitis?Judy W. Nee, MD, Anthony J. Lembo, MDJudy W. Nee, MDBeth Israel Deaconess Medical Center, Harvard Medical School, Boston, MassachusettsSearch for more papers by this author, Anthony J. Lembo, MDDigestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OhioSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L23-0416 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE: We thank Drs. Fujieda and Tanimoto for bringing up the role of abdominal ultrasonography in diagnosing acute diverticulitis. It is true that ultrasonography in expert hands has similar sensitivity and specificity to CT in diagnosing acute diverticulitis (1, 2); however, it may be less accurate in identifying such complications as abscesses as well as alternative diagnoses for acute abdominal pain. Although ultrasonography is recommended by the European Federation for Ultrasound in Medicine, other European guidelines recommend CT as the first-line investigative tool for the diagnosis of acute diverticulitis (3), with ultrasonography as an alternative (4). We agree with ...References1. Laméris W, van Randen A, Bipat S, et al. Graded compression ultrasonography and computed tomography in acute colonic diverticulitis: meta-analysis of test accuracy. Eur Radiol. 2008;18:2498-2511. [PMID: 18523784] doi:10.1007/s00330-008-1018-6 CrossrefMedlineGoogle Scholar2. Liljegren G, Chabok A, Wickbom M, et al. Acute colonic diverticulitis: a systematic review of diagnostic accuracy. Colorectal Dis. 2007;9:480-488. [PMID: 17573739] CrossrefMedlineGoogle Scholar3. Schultz JK, Azhar N, Binda GA, et al. European Society of Coloproctology: guidelines for the management of diverticular disease of the colon. Colorectal Dis. 2020;22 Suppl 2:5-28. [PMID: 32638537] doi:10.1111/codi.15140 CrossrefMedlineGoogle Scholar4. Sartelli M, Weber DG, Kluger Y, et al. 2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting. World J Emerg Surg. 2020;15:32. [PMID: 32381121] doi:10.1186/s13017-020-00313-4 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Judy W. Nee, MD; Anthony J. Lembo, MDAffiliations: Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MassachusettsDigestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OhioDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L23-0416. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHow Would You Manage This Patient With Recurrent Diverticulitis? Howard Libman , Judy W. Nee , Anthony J. Lembo , and Risa B. Burns How Would You Manage This Patient With Recurrent Diverticulitis? Takeshi Fujieda , and Tetsuya Tanimoto Metrics Current Issue January 2024Volume 177, Issue 1 Keywords Abdominal pain Antibiotics Colonoscopy Colorectal cancer Computed axial tomography Diverticulitis Randomized trials Surgery ePublished: 16 January 2024 Issue Published: January 2024 Copyright & PermissionsCopyright © 2024 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...