Trial reportInternational journal of colorectal disease2017
Predictive factors on CT imaging for progression of uncomplicated into complicated acute diverticulitis.
Trial report in International journal of colorectal disease, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- SAGES white paper on antibiotic omission in the management of acute uncomplicated diverticulitis: why, when, who, and most importantly, how.Surgical endoscopy · 2025Guideline
- German guideline diverticular disease/diverticulitis: Part II: Conservative, interventional and surgical management.United European gastroenterology journal · 2022Guideline
- AGA Clinical Practice Update on Medical Management of Colonic Diverticulitis: Expert Review.Gastroenterology · 2021Guideline
- Risk Prediction in Diverticulitis.Clinics in colon and rectal surgery · 2025Review
- Parameters of Body Composition Predict Clinical Course in Acute Colonic Diverticulitis.Journal of cachexia, sarcopenia and muscle · 2025Article
- Acute diverticulitis: beyond the diagnosis: predictive role of CT in assessing risk of recurrence and clinical implications in non-operative management of acute diverticulitis.La Radiologia medica · 2024Article
- Update on the management of sigmoid diverticulitis.World journal of gastroenterology · 2021Review
- Drains, Germs, or Steel: Multidisciplinary Management of Acute Colonic Diverticulitis.Digestive diseases and sciences · 2020Review
- Observational
- Colonic diverticular disease.Nature reviews. Disease primers · 2020Review
- Epidemiology, Pathophysiology, and Treatment of Diverticulitis.Gastroenterology · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
purposeSince outpatient treatment and omitting antibiotics for uncomplicated acute colonic diverticulitis have been proven to be safe in the majority of patients, selection of patients that may not be suited for this treatment strategy becomes an important topic. The aim of this study is to identify computed tomography (CT) imaging predictors for a complicated disease course of initially uncomplicated acute diverticulitis.
methodsCT imaging from a randomized controlled trial (DIABOLO study) of an observational vs. antibiotic treatment strategy of first-episode uncomplicated acute diverticulitis patients was re-evaluated. For each patient that developed complicated diverticulitis within 90 days after randomization, two patients with an uncomplicated disease course were randomly selected. Two abdominal radiologists, blinded for outcomes, independently re-evaluated all CTs.
resultsOf the 528 patients in the DIABOLO trial, 16 patients developed complications (abscess > 5 cm, perforation, bowel obstruction) within 90 days after randomization. In the group with a complicated course of initially uncomplicated diverticulitis, more patients with fluid collections (25 vs. 0%; p = 0.009) and a longer inflamed colon segment (86 ± 26 mm vs. 65 ± 21 mm; p = 0.007) were observed compared to an uncomplicated course of disease. Pericolic extraluminal air was no predictive factor.
conclusionFluid collections and to a lesser extent the length of the inflamed colon segment may serve as predictive factors on initial CT for a complicated disease course in patients with uncomplicated acute colonic diverticulitis. These findings may aid in the selection of patients not suitable for outpatient treatment and treatment without antibiotics.
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