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More bowel POCUS: A case of diverticulitis

February 4, 2014

This patient had LLQ pain. POCUS with the linear transducer and virtual concave on showed a tender area over the colon here and a small area of free fluid with the small bowel peristalsing around in the fluid. From this I made the diagnosis of diverticulitis. The CT confirmed this: a small area of oedematous sigmoid with a few tics, inflamed fat and the fluid noted above.


Diverticulitis can be appreciated on ultrasound by colonic edema, sometimes producing an image called the “pseudo kidney” sign as it resembles a kidney.  (The echogenic edema surrounding the echogenic bowel wall has a double density pattern like the cortex and collecting system of the kidney.)  Visualization of diverticulae and echogenic fecoliths within the bowel wall is much more specific.  It can be difficult to image affected bowel due to gas artifact so in general POCUS can be useful as a rule in test but should not be used to rule out the disease. [Ed.]



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