{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T01:11:13Z","timestamp":1771636273340,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2010,7,20]],"date-time":"2010-07-20T00:00:00Z","timestamp":1279584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2010,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The importance of inflammation markers in predicting perforation in acute sigmoid diverticulitis is not well known. Predicting perforation by clinical examination alone may be hazardous. If perforation is suspected, then appropriate diagnostic tools such as computed tomography (CT) are indicated, and surgical intervention might be necessary.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cohort of consecutive patients with acute sigmoid diverticulitis diagnosed by CT and with complete laboratory findings (<jats:italic>n<\/jats:italic> = 247) were retrospectively divided into two groups, one with perforation (<jats:italic>n<\/jats:italic> = 86) and another without (<jats:italic>n<\/jats:italic> = 161). The latest values of C\u2010reactive protein (CRP), white blood cell count (WBC), and serum bilirubin, as well as the activity of the alkaline phosphatase (AP) measured during the 48 h period before the CT scan, were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the Wilcoxon rank sum test CRP and WBC correlate significantly (<jats:italic>p<\/jats:italic> &lt; 0.05) with perforation in acute sigmoid diverticulitis, whereas the logistic regression model shows only CRP to correlate significantly (<jats:italic>p<\/jats:italic> = 0.001) with perforation. The sensitivities\/specificities for perforation are 98%\/5% for elevated CRP (&gt;5\u00a0mg\/l), 86%\/27% for a CRP higher than 50\u00a0mg\/l, 44%\/81% for a CRP higher than 150\u00a0mg\/l, 28%\/93% for a CRP higher than 200\u00a0mg\/l, 88%\/44% for elevated WBC (&gt;10 \u00d7 10<jats:sup>9<\/jats:sup>\/l), 35%\/90% for hyperbilirubinemia (&gt;20 \u03bcmol\/l), and 35%\/91% for elevated AP (&gt;110 U\/l).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A CRP below 50\u00a0mg\/l suggests a perforation to be unlikely in acute sigmoid diverticulitis, whereas a CRP higher than 200\u00a0mg\/l is a strong indicator of perforation.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-010-0726-7","type":"journal-article","created":{"date-parts":[[2010,7,19]],"date-time":"2010-07-19T19:48:46Z","timestamp":1279568926000},"page":"2717-2722","source":"Crossref","is-referenced-by-count":67,"title":["Diagnostic Value of Inflammation Markers in Predicting Perforation in Acute Sigmoid Diverticulitis"],"prefix":"10.1002","volume":"34","author":[{"given":"S. A.","family":"K\u00e4ser","sequence":"first","affiliation":[{"name":"Department of General, Visceral, Vascular and Thoracic Surgery Hospital of Liestal Rheinstrasse 26 4410 Liestal Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Fankhauser","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery Hospital of Tafers Maggenberg 1 1712 Tafers Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. M.","family":"Glauser","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Vascular and Thoracic Surgery Hospital of Liestal Rheinstrasse 26 4410 Liestal Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Toia","sequence":"additional","affiliation":[{"name":"Department of Radiology Hospital of Liestal Rheinstrasse 26 4410 Liestal Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph A.","family":"Maurer","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Vascular and Thoracic Surgery Hospital of Liestal Rheinstrasse 26 4410 Liestal Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,7,20]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10620\u2010007\u20100161\u20102"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572\u20100241.2005.41154.x"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/1\u20104020\u20104318\u2010X_7"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1984.01390150040010"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001340050715"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000102897"},{"key":"e_1_2_7_8_2","first-page":"1347","article-title":"Extremely high levels of alkaline phosphatase in adult patients as a manifestation of bacteremia","volume":"52","author":"Tung CB","year":"2005","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(80)90877-X"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.48.3.409"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2008.04.013"},{"key":"e_1_2_7_12_2","first-page":"536","article-title":"Remarks on pneumonia biliosa","volume":"1","author":"Garvin IP","year":"1837","journal-title":"S Med Surg J"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(76)80018-2"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440\u20101746.1999.01982.x"},{"key":"e_1_2_7_15_2","first-page":"859","volume-title":"Klinische pathophysiologie","author":"Moradpour D","year":"2006"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2008.08.026"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010007\u20100346\u20103"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.178.6.1781313"},{"key":"e_1_2_7_19_2","first-page":"85","article-title":"Treatment of perforated diverticular disease of the colon","volume":"12","author":"Hinchey E","year":"1978","journal-title":"Adv Surg"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-010-0726-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-010-0726-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-010-0726-7","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T23:35:22Z","timestamp":1703633722000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-010-0726-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,7,20]]},"references-count":18,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2010,11]]}},"alternative-id":["10.1007\/s00268-010-0726-7"],"URL":"https:\/\/doi.org\/10.1007\/s00268-010-0726-7","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,7,20]]}}}