Preliminary Diagnosis: Diverticulosis
I. What imaging technique is first-line for this diagnosis?
Contrast enhanced computed tomography (CECT). This includes intravenous and oral contrast, if available.
II. Describe the advantages and disadvantages of this technique for diagnosing diverticulosis.
Advantages
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Diagnostic for diverticulosis.
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Can show the extent of diverticulosis and any associated complications.
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Fast and requires no bowel preparation.
Disadvantages
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Exposure to ionizing radiation.
III. What are the contraindications for the first-line imaging technique?
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Iodinated contrast is contraindicated in patients with renal failure.
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CT is not recommended in early pregnancy.
IV. What alternative imaging techniques are available?
Double contrast barium enema.
V. Describe the advantages and disadvantages of the alternative techniques for diagnosing diverticulosis.
Advantages
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Double contrast barium enema can readily show diverticular disease as well as detect polyps.
Disadvantages
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Double contrast barium enema requires adequate bowel preparation and patient cooperation with air insufflation and rolling maneuvers during imaging.
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Radiation exposure maybe higher in comparison to CT. It is dependent on operator.
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Complications of diverticulosis are as easily identified.
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Risk of bowel perforation during air insufflation.
VI. What are the contraindications for the alternative imaging techniques?
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Patients who cannot tolerate the bowel preparation should consider CT.
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Active bowel perforation is a contraindication.
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