Publication:

Computed tomography predictors of progression and re-presentation in uncomplicated diverticulitis: a retrospective study at two regional Australian hospitals

Background Acute diverticulitis is a common presentation in Australian hospitals and is primarily assessed with computed tomography (CT). Identifying CT predictors of progression from uncomplicated to complicated diverticulitis, as well as risk factors for re-presentation, is crucial, particularly in regional hospitals with limited interventional radiology services.

Methods This retrospective study included 20 patients with CT-confirmed uncomplicated diverticulitis (WSES Grade 0, Hinchey Stage I) from Bundaberg Base Hospital (BBH) and Hervey Bay Hospital (HBH) between January 2023 and February 2024. Outcomes assessed were progression to complicated diverticulitis and re-presentation within three months. CT features (e.g., free fluid, free air, abscess formation, wall thickening, fat stranding) and clinical variables (e.g., C-reactive protein CRP) were analyzed. Statistical tests included Fisher’s exact test and t-tests, with significance set at p 30 days, ≤90 days) suggested recurrence.

Conclusion Abscess, free fluid, free air, and elevated CRP (>100 mg/l) were predictors of progression to complicated diverticulitis, with abscess reaching statistical significance. No definitive CT predictors for re-presentation were identified. Structured CT reporting and prioritization of high-risk patients for admission are particularly important in regional settings with inconsistent interventional radiology access.