Andeweg et al developed a clinical nomogram for the diagnosis of acute left-sided diverticulitis. The authors are from Radboud University and Nijmegen Medical Centre in The Netherlands.
Patient selection: acute abdominal pain
Parameters:
(1) age in years
(2) previous episode of diverticulitis (one or more)
(3) abdominal tenderness
(4) symptoms
(5) aggravation of pain on movement
(6) vomiting
(7) serum C-reactive protein in mg/L
Parameter
Finding
Points
age
<= 50 years
0
>= 51 year
40
previous episodes
no
0
yes
88
abdominal tenderness
left-sided
57
other (diffuse, right-sided)
0
symptoms
right
0
diffuse
71
left
100
aggravated by movement
no
0
yes
62
vomiting
yes
0
no
50
serum CRP
<= 10 mg/L
0
11 to 49 mg/L
35
>= 50 mg/L
85
where:
• The nomogram refers to ages <= 70 and >= 71 but text refers to <= 50 and >= 51.
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 482
• The higher the score the greater the likelihood of acute left-sided diverticulitis.
Total Score
Probability of Left-Sided Diverticulitis
< 127
< 5%
127 to 482
X = (0.01932 * (score)) - 5.405;
probability = 1/(1+EXP((-1)*X))
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