Decoding the complexity of small bowel and colon diverticular disease through radiological perspectives: closing the gap in imaging insights and enhancing treatment efficacy

Abstract

Diverticular disease, marked by diverticula (saccular outpouchings) in the gastrointestinal tract, is becoming increasingly common and presents significant challenges in diagnosis and management. Diverticulosis refers to multiple diverticula, whereas diverticulitis denotes inflamed and symptomatic diverticula. The pathology of diverticulitis involves obstruction of the diverticular ostia, leading to inflammation and necessitating accurate diagnosis and effective management. Imaging modalities, particularly ultrasonography (US) and computed tomography (CT), have largely replaced barium studies and are crucial in evaluation. US demonstrates noncompressible outpouchings with characteristic features, whereas CT remains the gold standard for assessing disease severity, bowel segment involvement, and associated complications. Complications, including perforations, phlegmon, abscesses, intestinal obstruction, bleeding, and fistulas, require prompt intervention to reduce morbidity and mortality. This pictorial review highlights the imaging features of uncomplicated and complicated diverticular diseases of the small and large intestines.

Keywords

• colon
• computed tomography
• diverticulitis
• diverticulum
• duodenum
• ileal
• jejunum
• meckel’s diverticulitis
• small bowel
• ultrasonography