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J Korean Soc Radiol. 2015 Aug;73(2):91-99. English. Original Article.
Kim DH , Kim HJ , Jang SK , Yeon JW , Ko Y , Lee KH .
Department of Radiology, Daejin Medical Center Bundang Jesaeng General Hospital, Seongnam, Korea.
Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
Program in Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea.

PURPOSE: The purpose of this report is to retrospectively analyze the need for surgery, and the recurrence rate, using a CT-based method in patients with right colonic diverticulitis. MATERIALS AND METHODS: For the purposes of our study, we included 416 patients with a mean age of 41.9 (238 of which were men), with a diagnosis of colonic diverticulitis that was based on CT findings. These findings were reviewed by two independent radiologists, who localized diverticulitis and determined it using a modified Hinchey classification. We were able to follow-up with 384 patients over a period of 30 months. RESULTS: Out of the 416 patients, 396 of them had right colonic diverticulitis. In right colonic diverticulitis, the kappa value in determining the modified Hinchey classification was 0.80. 98.2% (389/396) of the patients with right colonic diverticulitis had stages Ia-II. The surgery rate was 4.6% (17/366) and 28% (5/18) for right and left colonic diverticulitis, respectively (p < 0.001). In the instances of right colonic diverticulitis, the surgery rate was 2.8% (10/359) for stages Ia-II, while all seven patients with stage III or IV underwent surgery. The recurrence rate was 6.5% (23/356) and 15% (2/13) for right and left colonic diverticulitis, respectively (p = 0.224). CONCLUSION: The CT-based modified Hinchey classification of right colonic diverticulitis showed good interobserver agreement. Most patients with right colonic diverticulitis had lower stages (Ia-II) at the point of CT, rarely needed surgery, and had a low recurrence rate.

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