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KMID : 1103720150730020091
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Journal of the Korean Society of Radiology
2015 Volume.73 No. 2 p.91 ~ p.99
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The Surgical Rate and Recurrence Rate in Right Colonic Diverticulitis Using the CT-Based Modified Hinchey Classification
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Kim Dong-Hwan
Kim Hyuk-Jung
Jang Suk-Ki
Yeon Jae-Woo
Ko You-Sun
Lee Kyoung-Ho
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Abstract
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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 κ 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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KEYWORD
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CT, Colon, Diverticulitis, Surgery, Recurrence
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