Diagnostic evaluation

A. Plain X-rays may show ileus, obstruction, mass effect, ischemia, or perforation.

B. CT scan is the test of choice to evaluate acute diverticulitis. The CT scan can be used for detecting complications and ruling out other diseases.

C. Contrast enema. Water soluble contrast is safe and useful in mild-to-moderate cases of diverticulitis when the diagnosis is in doubt.

D. Endoscopy. Acute diverticulitis is a relative contraindication to endoscopy; perforation should be excluded first. Endoscopy is indicated when the diagnosis is in doubt to exclude the possibility of ischemic bowel, Crohn's disease, or carcinoma.

E. Complete blood count may show leukocytosis.

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