Diagnostic Accuracy of Bedside Ultrasound in Suspected Acute Diverticulitis
Diagnostic Accuracy of Bedside Ultrasound in Suspected Acute Diverticulitis
Colonic diverticulitis is a common clinical condition in patients presenting to the Emergency
 Department (ED) with abdominal pain. The diagnosis and staging of patients with suspected
 acute diverticulitis is often made by CT imaging with intravenous contrast, which involves
 radiation exposure, is expensive and has contraindications. The aim of this study is to
 evaluate the diagnostic accuracy and role of bedside abdominal US for the diagnosis of acute
 diverticulitis
Colonic diverticulitis is a common clinical condition; about 20% of patients with colonic
 diverticulosis experience abdominal symptoms and, eventually, complications such as episodes
 of diverticulitis or bleeding. The distinction between patients with uncomplicated or
 complicated diverticulitis affects the clinical management: medical therapy for the first,
 interventional therapy for the latter. CT imaging with intravenous contrast has become the
 gold standard in the diagnosis and staging of patients with suspected acute diverticulitis
 but, unfortunately, CT involves radiation exposure, is expensive and has contraindications.
 UltraSound (US) is a real-time dynamic examination with wide availability and easy
 accessibility and may be useful in diagnosing and managing critically ill patients who cannot
 be moved to CT. In a recent meta-analysis, US exam performed by Radiologists showed a pooled
 sensitivity of 90% (vs 95% for CT, p = 0.86) and a specificity of 90% (vs 96% for CT, p =
 0.04). US is increasingly used at bedside to rapidly assess patients presenting to the
 Emergency Department. No previous studies have investigated the diagnostic accuracy of
 abdominal US performed by physician at bedside as an extension of physical examination. This
 study evaluates the diagnostic accuracy of bedside abdominal US.
Inclusion Criteria:

 -  informed consent obtained

 -  patients with abdominal pain presenting to the Emergency Department with a suspicon of
 diverticular disease, in whom the tutor physician orders an imaging study (abdominal
 CT or abdominal US performed by the Radiologist)

 Exclusion Criteria:

 -  no ultrasonographer physician who can perform bedside abdominal US is present

 -  the patient does not undergo imaging study

 -  clinical conditions of the patient are particularly severe, preventing an adequate
 enrollment