Differences between computed tomoghaphy and surgical findings in acute complicated diverticulitis
Summary Background/Objective: A preoperative reliable classification system between
clinical and computed tomography (CT) findings to better plan surgery in acute complicated
diverticulitis (ACD) is lacking. We studied the inter-observer agreement of CT scan data and
their concordance with the preoperative clinical findings and the adherence with the intraoperative
status using a new classification of diverticular disease (CDD).
Methods: 152 patients operated on for acute complicated diverticulitis (ACD) were retrospectively
enrolled. All patients were studied with CT scan within 24 h before surgery and CT images
were blinded reanalyzed by 2 couples of radiologists (A/B). Kappa value evaluated the
inter-observer agreement between radiologists and the concordance between CDD, preoperative
clinical findings and findings at operation. Univariate and multivariate analysis were used
to evaluate the predicting values of CT classification and CDD stage at surgery on postoperative
outcomes.
Results: Overall inter-observer agreement for the CDD was high, with a kappa value of 0.905
(95% CI Z 0.850e0.960) for observers A and B, while the concordance between radiological