Acute XXXX : safety and value of contrast studies in predicting need for operation.

@entity1 @entity66 @entity254 @entity7261 @entity5173 @entity2473 @entity4436 @entity298 @entity4570
Results of treatment of 70 @entity1 hospitalized with acute @entity4436 were analysed to determine the value of early contrast enema in management. A water-soluble enema done during the first week of hospitalization in 48 @entity1 showed @entity7261 with @entity2473 (30), a leak or peridiverticulitis (16) and a normal study (two). No complications were caused by the study. Forty @entity1 improved on medical therapy, but four relapsed after discharge. Thirty-four (49%) @entity1 had urgent operation during hospitalization for the acute episode of @entity4436 . Findings on contrast enema correlated with the need for surgery during the acute phase: 13 of 16 with peridiverticulitis or a leak compared with three of 30 with @entity7261 / @entity2473 (P less than 0.001). Operations performed were: sigmoid resection and primary @entity254 (17) with covering colostomy (five). Hartmann's operation (eight), @entity5173 (seven), right hemicolectomy (two). Findings at surgery were: abscess (15), phlegmon (12), @entity298 (five) and @entity4570 (two). It is concluded that early contrast enemas of the distal colon done with appropriate precautions are useful in confirming the diagnosis of @entity66 : only two of 48 studies were falsely negative. A pericolic extravasation (as opposed to a small sinus tract) or abscess usually indicates need for operation, whereas the finding of @entity7261 / @entity2473 suggests a favourable outcome of conservative management.
