Keywords:
Obstruction / Occlusion, Neoplasia, Diverticula, Diagnostic procedure, Ultrasound, Oncology, Gastrointestinal tract, Abdomen
Authors:
C. P. Fernandez Ruiz1, T. Ripollés2, M. J. Martinez1, D. Gomez3, E. Garcia Martinez1, L. Navarro Vilar4; 1Valencia/ES, 246007/ES, 3CO, 4Alfafar (Valencia), Va/ES
DOI:
10.1594/ecr2013/C-2193
Results
We found a total of 44 patients ranging in age from 38-87 years.
26 were men and 18 were women. Fig. 14
32 patients corresponded to 73%,
that came from the emergency department and 12% of them came from the outpatient.
The diagnosis of stenosis was performed by CT in 73%,
colonoscopy 16% ,
barium enema in 11%.
The final diagnosis was diverticulitis in 29 patients corresponded to 66% and neoplasia in 15 patients with 34%.
The morphological characteristics with higher sensitivity for neoplasia were loss of layer structure and a length less than 10 cm with 14 of 15 patients that corresponds to 93% and then the eccentric stenosis with 13 of 15 patients that corresponds to 87%.
We found no malignancies in patients who had no lymphadenopathy, showing 100% specificity for malignancy and found only two cases of neoplasia in patients thickening of <15mm,
with a specificity of 93% but with a very low sensitivity.
These last two parameters were highly specific but insensitive.
The absence of diverticula was more indicative of tumor with a sensitivity of 73% and a high specificity of 90% but with a lower sensitivity value in CT studies reported in the literature previously.
Regarding diverticulitis,
the criteria more sensitive was folds preservation with 26 of 29 patients with 90% and the thickening of the muscle layer en 24 patients de 29 patients con 83%of sensitivity,
with high values of specificity . Fig. 16
The presence of fistula had a specificity of 100% for diverticulitis but with low sensitivity.
The conservation of the inner layers was observed in only one of 15 tumors which gave us a specificity of 93%
Parameters such alteration or the presence of fat collections were not differentiating factors in our group of patients.
The sensitivity of the final report of ultrasound was 93% and that of CT was 87%. Fig. 17