Digestive disorders

II/4.5: Diagnostics

During physical examination tenderness to pressure can be observed on the left side in the sigmoid area. In patients with diverticulitis the pain is more intense and a resistance can be felt possibly accompanied by a muscular defense. In the most severe cases (perforation) signs and symptoms of peritonitis and sepsis are present.

Colonoscopy is the diagnostic procedure of first choice for demonstrating diverticulosis; its performance is contraindicated in patients with acute diverticulitis, due to an increased risk of perforation (it can be performed after 6 to 8 weeks) .

Double contrast irrigoscopy has been replaced by colonoscopy. Diverticula and their environment can be imaged well also by virtual colonoscopy. Imaging procedures (native abdominal ultrasound [US], computer tomography [CT], magnetic resonance imaging [MRI]) have also significance in the detection of complications (perforation, ileus). The US and CT examinations are also helpful in targeted punctures of discharge (drainage).

Laboratory tests may indicate inflammation, diverticulitis (erythrocyte sedimentation rate, leukocytosis, C-reactive protein), acute or chronic blood loss.