Acute left-sided colonic diverticulitis: clinical expressions, therapeutic insights, and role of computed tomography

Figures & data

Table 1 Revised CT classification

Classification	CT performed with IV-contrast and water-soluble rectal contrast
1.	Uncomplicated acute diverticulitis
	Site: proximal or distal descending colon/proximal or distal sigmoid
	Length of inflammation (cm)
	Maximal thickness (cm)
	Inflammation of pericolic fat (phlegmon)
2.	Complicated acute diverticulitis (classification 1 + one or more of the following findings)
	Abscess(es): mesocolic/pelvic/abdominal (maximum diameter in cm)
	Contrast extravasation: mesocolic/peritoneal
	Free air: mesocolic/pericolic/at distance (maximum diameter in cm)
	Free fluid: mesocolic/peritoneal (volume in mL)
3.	Complicated chronic diverticulitis
	Fistula
	Stenosis

Abbreviation: CT, computed tomography.

Table 2 Revised clinical classification

1. Uncomplicated diverticulitis

Phlegmonous diverticulitis

2. Complicated diverticulitis

2.1. Abscess

Site(s)

Mesenteric

Pelvic

Abdominal

Size (cm)

2.2. Colonic perforation

Mesenteric

Peritoneal

Localized purulent peritonitis

Generalized purulent peritonitis

Fecal peritonitis

3. Recurrent diverticular disease

Recurrent episode(s) of acute diverticulitis

4. Recurrent symptomatic diverticular disease

4.1. Irritable bowel syndrome-like diverticular disease

4.2. Symptomatic uncomplicated diverticular disease

5. Chronic diverticulitis

5.1. Fistula

5.2. Stenosis