Ultrasound diagnosis of diverticulitis.

Diverticular disease accounts for approximately 312 000 hospital admissions in the United States annually, and costs nearly 2.6 billion dollars.[1,2] Approximately 20% of Americans with diverticular disease will experience at least one episode of acute diverticulitis, necessitating a visit to their physician’s office or the emergency department (ED) for treatment.[3] As the risk of developing diverticulitis rises with age (nearly 50% of people aged over 60 years have colonic diverticula), the incidence is rising as the elderly population grows.[4] The majority of the patients are treated non-operatively, with a course of oral antibiotics and diet modification. Although computed tomography (CT) imaging is considered the “gold standard” for the diagnosis of acute diverticulitis in the United States, ultrasound is routinely used in Europe, Asia, and Africa as the initial imaging modality of choice in the evaluation of patients with suspected diverticulitis. Recent studies[5,6] have suggested that there is no significant difference in the test performance characteristics of CT as opposed to ultrasound for the diagnosis of diverticulitis. We present two cases in which point-of-care ultrasound was used to diagnose acute uncomplicated diverticulitis in the ED.