Year 2022 Vol. 30 No 6

SCIENTIFIC PUBLICATIONS

.I. OUSHNEROU 2, I.A. HADJI-ISMAIL 1, A.V. VARABEI 2, S.I. RUDENKA 1

FEATURES OF ULTRASOUND DIAGNOSTICS IN ACUTE COMPLICATIONS OF DIVERTICULAR DISEASE OF THE COLON

Belarusian Medical Academy of Postgraduate Education 1,
Medical Centre NeoMedial 2, Minsk,
Republic of Belarus

Objective. To analyze and systematize the results of ultrasound scan in patients with acute complications of diverticular disease of the colon.
Methods. The results of ultrasound scan of the intestine were analyzed in 57 patients who complained of acute abdominal pain, flatulence and stool abnormalities, who had diverticular disease of the colon. Of these, 31 (54,4%) were women and 26 (45,6%) were men. In 49 (86%) patients, diverticula were located in the left side of the colon, in 6 (10,5%) patients, diverticula were located in the right side of the colon and 2 (3,5%) patients, diverticula were found all over colon.
Result. A preliminary ultrasound classification of acute complications of diverticular disease of the colon according to the severity of the course (4 degrees) has been developed. The first degree indicates an inflamed diverticulum with/without pericolitis, with/without abscess ≤2 cm in diameter regardless of localisation in relation to the mesenteric and anti-mesenteric margins. The second degree indicates an inflamed diverticulum with an abscess >3 cm in diameter or with a diverticulum perforation along the mesenteric margin, as well as with an abscess >2cm and with a perforation along the anti-mesenteric margin. The third degree is characterized by focal or generalized purulent peritonitis. The fourth degree - development of faecal peritonitis.
Conclusion. Ultrasound is safe, non-invasive, easy and affordable, It allows at once visualize not only the entire gastrointestinal tract, but also other organs and systems, in parallel interpret both clinical and ultrasound data, classify patients into outpatient and inpatient depending on the severity of complications of diverticular disease of the colon.

Keywords: diverticular disease, colon, ultrasound, complication, classification
p. 518-527 of the original issue
References
  1. Ambrosetti P, Chautems R, Soravia C, Peiris-Waser N, Terrier F. Long-term outcome of mesocolic and pelvic diverticular abscesses of the left colon: a prospective study of 73 cases. Dis Colon Rectum. 2005 Apr;48(4):787-91. doi: 10.1007/s10350-004-0853-z
  2. Vorobev GI, Pancyrev JuM, Zhuchenko AP, Achkasov SI, Manvelidze AG, Moskalev AI, Bolihov KV. Ostryj divertikulit sigmovidnoj kishki: klinika, diagnostika i lechenie. Med Vestn Bashkortostana. 2008;3(3):12-19. (In Russ.)
  3. Baker ME. Imaging and interventional techniques in acute left-sided diverticulitis. J Gastrointest Surg. 2008 Aug;12(8):1314-17. doi: 10.1007/s11605-008-0490-2
  4. Sheiman L, Levine MS, Levin AA, Hogan J, Rubesin SE, Furth EE, Laufer I. Chronic diverticulitis: clinical, radiographic, and pathologic findings. AJR Am J Roentgenol. 2008 Aug;191(2):522-28. doi: 10.2214/AJR.07.3597
  5. Norsa AH, Tonolini M, Ippolito S, Bianco R. Water enema multidetector CT technique and imaging of diverticulitis and chronic inflammatory bowel diseases. Insights Imaging. 2013 Jun;4(3):309-20. doi: 10.1007/s13244-013-0239-7
  6. Rafferty J, Shellito P, Hyman NH, Buie WD; Standards Committee of American Society of Colon and Rectal Surgeons. Practice parameters for sigmoid diverticulitis. Dis Colon Rectum. 2006 Jul;49(7):939-44. doi: 10.1007/s10350-006-0578-2
  7. Frush DP, Applegate K. Computed tomography and radiation: understanding the issues. J Am Coll Radiol. 2004 Feb;1(2):113-19. doi: 10.1016/j.jacr.2003.11.012
  8. Horuzhik SA, Mihajlov AN. Doza obluchenija pri kompjuterno-tomograficheskih issledovanijah: dozimetricheskie parametry, izmerenie, sposoby snizhenija, radiacionnyj risk. Vestn Rentgenologii i Radiologii. 2007;(6):53-62. https://elibrary.ru/item.asp?id=15183864 (In Russ.)
  9. Kaiser AM, Jiang JK, Lake JP, Ault G, Artinyan A, Gonzalez-Ruiz C, Essani R, Beart RW Jr. The management of complicated diverticulitis and the role of computed tomography. Am J Gastroenterol. 2005 Apr;100(4):910-17. doi: 10.1111/j.1572-0241.2005.41154.x
  10. Laméris W, van Randen A, Bipat S, Bossuyt PM, Boermeester MA, Stoker J. Graded compression ultrasonography and computed tomography in acute colonic diverticulitis: meta-analysis of test accuracy. Eur Radiol. 2008 Nov;18(11):2498-511. doi: 10.1007/s00330-008-1018-6
  11. Laméris W, van Randen A, van Gulik TM, Busch OR, Winkelhagen J, Bossuyt PM, Stoker J, Boermeester MA. A clinical decision rule to establish the diagnosis of acute diverticulitis at the emergency department. Dis Colon Rectum. 2010 Jun;53(6):896-904. doi: 10.1007/DCR.0b013e3181d98d86
  12. oushnerou AI, Hadzhi-Ismail IA, Vorobej AV, Rudenko SI. Ultrazvukovaja diagnostika oslozhnennoj divertikuljarnoj bolezni obodochnoj kishki. Zdravoohranenie. 2021;(6):63-71. https://www.zdrav.by/hirurgiya/ultrazvukovaya-diagnostika-oslozhnennoj-divertikulyarnoj-bolezni-obodochnoj-kishki/ (n Russ.)
  13. Andeweg CS, Felt-Bersma R, Verbon A, Stoker J, Boermeester M, Bleichrodt R. Summary of the practice guideline on diverticulitis in the colon: diagnostics and treatment in specialty care. Ned Tijdschr Geneeskd. 2013;157(15):A6124. [Article in Dutch]
  14. Andeweg CS, Mulder IM, Felt-Bersma RJ, Verbon A, van der Wilt GJ, van Goor H, Lange JF, Stoker J, Boermeester MA, Bleichrodt RP; Netherlands Society of Surgery; Working group from Netherlands Societies of Internal Medicine, Gastroenterologists, Radiology, Health echnology Assessment and Dieticians. Guidelines of diagnostics and treatment of acute left-sided colonic diverticulitis. Dig Surg. 2013;30(4-6):278-92. doi: 10.1159/000354035
  15. Trubacheva JuL, Orlova LP, Moskalev AI, Skridlevskij SN, Belov DM, Shahmatov DG, Achkasov SI. Ultrasound diagnosis of chronic paracolic inflammatory mass in diverticular disease. Hirurgija. Zhurn im. N.I. Pirogova. 2020;9:14-19. doi: 10.17116/hirurgia202009114 (In Russ.)
  16. oushnerou AI, Hadzhi-Ismail IA, Vorobej AV, Rudenko SI. Comprehensive Ultrasound Diagnosis of Sigmoid Diverticulitis. Ros Zhurn Gastrojenterologii, Gepatologii, Koloproktologii. 2021;31(4):45-54. doi: 10.22416/1382-4376-2021-31-4-45-54 (In Russ.)
  17. Puylaert JB. Ultrasound of acute GI tract conditions. Eur Radiol. 2001;11(10):1867-77. doi: 10.1007/s003300101076
  18. Puylaert JB. Ultrasound of colon diverticulitis. Dig Dis. 2012;30(1):56-59. doi: 10.1159/000336620
  19. Shelygin YuA, Achkasov SI, Moskalev AI. Classification of diverticular disease. Koloproktologija. 2014;(4):5-13. https://elibrary.ru/item.asp?id=22616014 (In Russ.)
  20. Klarenbeek BR, de Korte N, van der Peet DL, Cuesta MA. Review of current classifications for diverticular disease and a translation into clinical practice. Int J Colorectal Dis. 2012 Feb;27(2):207-14. doi: 10.1007/s00384-011-1314-5
  21. Sher ME, Agachan F, Bortul M, Nogueras JJ, Weiss EG, Wexner SD. Laparoscopic surgery for diverticulitis. Surg Endosc. 1997 Mar;11(3):264-67. doi: 10.1007/s004649900340
  22. Kushnerov AI. Ultrazvukovaja diagnostika novoobrazovanij tolstoj kishki. Prakticheskoe rukovodstvo. Moscow, RF: Med. lit.; 2014. 119 p. (In Russ.)
  23. Butorova LI. Divertikuljarnaja bolezn tolstoj kishki: klinicheskie formy, diagnostika i lechenie: posobie dlja vrachej. Mosow, RF: 4TE Art; 2011. 48 s. http://www.mucofalk.ru/ data/download/butorova-divert.pdf (In Russ.)
  24. . Orlova LP. Trubacheva Yu.L., Markova E.V. Colonic diverticulitis: diagnostic value and appearance of inflamed diverticula echographic evaluation. Ultrazvukovaja i Funktion Diagnostika. 2008;(3):18-25. (In Russ).
Address for correspondence:
223041, Republic of Belarus,
Minsk region, Minsk district, a/g Lesnoy-1.
Belarusian Medical Academy of Postgraduate Education, Department of Surgery,
Tel. +375 44 7514263,
e-mail: docismailabbas@gmail.com,
Haji Ismail Ismail Abbas
Information about the authors:
Koushnerou Alexandr I., MD, Professor, Medical Center NeoMedical, Minsk, Republic of Belarus.
https://orcid.org/0000-0002-1012-5101
Haji-Ismail Ismail Abbas, PhD, Associate Professor, Belarusian Medical Academy of Postgraduate Education, Department of Surgery, Minsk, Republic of Belarus.
https://orcid.org/0000-0001-9588-7422
Varabei Aliaksandr V., MD, Professor, Corresponding Member of the National Academy of Sciences of the Republic of Belarus, Minsk, Republic of Belarus.
https://orcid.org/0000-0002-9765-2755
Rudenka Svetlana I., PhD, hysician (ultrasound) at the NeoMedical Medical Center, Minsk, Republic of Belarus.
https://orcid.org/0000-0002-6066-0153
Contacts | ©Vitebsk State Medical University, 2007-2023