To describe the adequate sonographic technique to evaluate the bowel To access ultrasound (US) value in the diagnosis and management of acute diverticulitis and summarize its features To illustrate cases of diverticulitis and correlate the ultrasound signs with computed tomography (CT) findings, when available To outline the main pitfalls and limitations of this imaging technique

Diverticular disease is increasingly common in the western world. Acute diverticulitis may be clinically suspected when the triad of left lower quadrant pain, fever and leukocytosis with neutrophilia is present. However, misdiagnose based solely on clinical ground was estimated to be 33-67%, which emphasizes the importance of imaging confirmation. There is contradictory evidence regarding the use of US in the diagnosis of acute diverticulitis. Even though abdominopelvic CT with intravenous contrast is the recommended imaging technique for the initial evaluation of a left quadrant pain...

Abdominal scanning is performed with a curvilinear probe (frequency 3,5-5 MHz) in most cases, but a high frequency linear probe (5-12 MHz) may also be used for greater resolution. An endocavitary probe may be used as well to evaluate areas of difficult access, such as the sigmoid colon, keeping in mind that this approach is more invasive. Normal colon has a thin wall and is characterized by its anatomic position, lack of peristalsis and presence of haustra. When there is an underlying disease the colonic...

CT continues to be the preferred imaging method for diagnosing acute diverticulitis, mainly because US has technical limitations and is operator dependent. Furthermore, diagnostic accuracy is highly compromised by obesity or interposing gas and is unsatisfactory to visualize areas deeply seated, such as the sigmoid colon. Additionally, even though US may identify the presence of an abscess, fistula or stenosis, CT is better in diagnosing complications and staging diverticulitis. Despite its limitations, US plays an important role when CT is not available or is contraindicated,...

M. Machado; Faro/PT - nothing to disclose P. M. G. Alves; Faro/PT - nothing to disclose R. Martins; Faro/PT - nothing to disclose A. S. Teixeira Gomes; Lisbon/PT - nothing to disclose

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