Initial evaluation and imaging in acute left-sided diverticulitis

Acute left-sided diverticulitis is a highly prevalent condition leading to a significant number of hospitalizations each year. Surgeons are commonly asked to evaluate and treat patients with suspected diverticulitis. The initial evaluation is focused on a symptom specific history and physical examination, as well as patient stability. Patient symptoms and examination often differentiate diverticulitis from other conditions and provide clues about potential sequelae. Laboratory evaluation includes assessment for anemia and leukocytosis, and parameters of volume including a renal function panel. Additional labs such as C-reactive protein may provide utility in the assessment of disease severity. Imaging plays a critical role in the diagnosis and evaluation of acute left-sided diverticulitis. Computed tomography scan (CT scan) is the imaging modality of choice as it is widely available, reproducibly interpreted, highly sensitive and specific, and can assess for complications such as abscess, obstruction, and fistula. In patients who are unable to undergo CT scan, ultrasound and magnetic resonance imaging may be considered as alternatives. Published by Elsevier Inc.