Simsar M, Yuruk YY, Sahin O, Sahin H. Radiological insights into diverticulitis: Clinical manifestations, complications, and differential diagnosis. World J Radiol 2025; 17(8): 107463 [DOI: 10.4329/wjr.v17.i8.107463]
Corresponding Author of This Article
Hilal Sahin, MD, Associate Professor, Department of Radiology, University of Health Sciences, Izmir City Hospital, Şevket ince mahallesi, 2148/11. Sokak No: 1/11, Izmir 35540, Türkiye. hilal.sahin1@sbu.edu.tr
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Aug 28, 2025; 17(8): 107463 Published online Aug 28, 2025. doi: 10.4329/wjr.v17.i8.107463
Radiological insights into diverticulitis: Clinical manifestations, complications, and differential diagnosis
Mehmet Simsar, Yesim Y Yuruk, Olgun Sahin, Hilal Sahin
Mehmet Simsar, Olgun Sahin, Hilal Sahin, Department of Radiology, University of Health Sciences, Izmir City Hospital, Izmir 35540, Türkiye
Yesim Y Yuruk, Department of Radiology, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir 35020, Türkiye
Author contributions: Simsar M and Sahin H conceptualized and designed the study; Simsar M, Yuruk YY, and Sahin O conducted the literature review, carried out the analysis, drafted the original manuscript, and made critical revisions; Sahin H supervised the review, advised the review design, and critically revised the manuscript. All authors prepared the draft and approved the submitted version.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hilal Sahin, MD, Associate Professor, Department of Radiology, University of Health Sciences, Izmir City Hospital, Şevket ince mahallesi, 2148/11. Sokak No: 1/11, Izmir 35540, Türkiye. hilal.sahin1@sbu.edu.tr
Received: March 24, 2025 Revised: June 10, 2025 Accepted: August 6, 2025 Published online: August 28, 2025 Processing time: 157 Days and 12.4 Hours
Abstract
Diverticulitis is an infection of the diverticular sacs protruding from the intestinal wall. It typically presents as elevated inflammatory markers and left lower quadrant abdominal pain. Although clinical symptoms and biomarkers are essential for diagnosis, imaging methods, particularly computed tomography (CT), are critical due to the inability to perform endoscopic procedures in the acute phase because of the risk of perforation. Various classification systems that include imaging findings have been developed. The most recent and widely accepted system is the Sartelli classification, which is endorsed by the World Society of Emergency Surgery. This classification describes stages of diverticulitis ranging from edematous bowel wall thickening and phlegmon in the adjacent mesentery to microperforation, localized or distant abscess formation, and generalized peritonitis with free fluid and air. Imaging findings are also pivotal in diagnosing and managing complications such as abscesses, pylephlebitis, fistulas, and gastrointestinal bleeding. Moreover, imaging can differentiate diverticulitis from infectious colitis, epiploic appendagitis, ischemic colitis, colorectal carcinoma, and inflammatory bowel disease. This review focuses on the radiological findings of diverticulitis. We specifically discuss CT imaging and emphasize its clinical manifestations, significant complications, and differential diagnosis.
Core Tip: Abdominal pain is one of the most common complaints leading to emergency department visits. A significant proportion of patients presenting with elevated inflammatory markers are diagnosed with diverticular disease, including diverticulitis and its complications. A standardized classification system and computed tomography imaging are crucial for ensuring accurate diagnosis and appropriate treatment. This review provides a comprehensive overview of the imaging findings, classification, and complications of diverticulitis.
