High-resolution sonographic spectrum of diverticulosis, diverticulitis, and their complications.

OBJECTIVE The purpose of this study was to evaluate the high-resolution sonographic features of diverticulosis, diverticulitis, and their complications. METHODS During a period of about 4 years 8 months, there were 25 patients with sonographic features of diverticulosis, uncomplicated diverticulitis, and complicated diverticulitis. The clinical symptoms, sonographic features, follow-up investigations, and management details were recorded. RESULTS The common symptoms were pain in the left lower quadrant and fever. Sonographic features of uncomplicated diverticulitis were a varying appearance of the diverticulum with pericolic inflammation. Colonic wall thickening was not a consistent sign. Complications seen were pericolic, mesocolic, and intraperitoneal abscesses, colovesical fistulas, colouterine fistulas, perforation, and small-bowel obstruction. Uninflamed diverticula were seen in all patients with left-sided disease. They had 7 types of sonographic appearances. CONCLUSIONS Uncomplicated diverticulitis is seen as a diverticulum of variable echogenicity with pericolic inflammation. An inflamed diverticulum is not visualized in complicated diverticulitis. Visualization of uninflamed diverticula helps reinforce the diagnosis of uncomplicated diverticulitis and predict the cause in complicated diverticulitis.