ultrasound is non-compressing outpouching of bowel wall, hypoechoic and thickened wall, or there is obstructive fecalith at the bowel wall. Besides, bowel wall oedema with adjacent hyperechoic mesentery can also be seen on ultrasound. However, CT scan is the mainstay of diagnosing diverticulitis and its complications. The diagnosis of acute diverticulitis is made confidently when the involved segment contains diverticula. CT images reveal localized colon wall thickening, with inflammation extending into the fat surrounding the colon. Amongst the complications that can be seen on CT scan are: abscesses, perforation, pylephlebitis, intestinal obstruction, bleeding, and fistula. Barium enema and colonoscopy are contraindicated in the acute phase of diverticulitis because of the risk of perforation. Classification by severity Four classifications by severity have been published recently in the literature. The most recent and widely accepted is as follows: Stage 0 – asymptomatic diverticulosis Stage 1a – uncomplicated diverticulitis Stage 1b – diverticulitis with phlegmonous peridiverticulitis Stage 2a – diverticulitis with concealed perforation, and abscess with a diameter of one centimeter or less Stage 2b – diverticulitis with abscess greater than one centimeter Stage 3a – diverticulitis with symptoms but without complications Stage 3b – relapsing diverticulitis without complications Stage 3c – relapsing diverticulitis with complications The severity of diverticulitis can be radiographically graded by the Hinchey Classification. Differential diagnoses The differential diagnoses include colon cancer, inflammatory bowel disease, ischemic colitis, and irritable bowel syndrome, as well as a number of urological and gynecological processes. In those with uncomplicated diverticulitis, cancer is present in less than 1% of people. Treatment Most cases of simple, uncomplicated diverticulitis respond to conservative therapy with bowel rest. Diet People may be placed on a low-fiber diet. It was previously thought that a low-fiber diet gives the colon adequate time to heal. Evidence tends to run counter to this, with a 2011 review finding no evidence for the superiority of low-fiber diets in treating diverticular disease, and that a high-fiber diet may prevent diverticular disease. A systematic review published in 2012 found no high-quality studies, but found that some studies and guidelines favour a high-fiber diet for the treatment of symptomatic disease. While it has been suggested that probiotics may be useful for treatment, the evidence currently neither supports nor refutes this claim. Antibiotics Mild uncomplicated diverticulitis without systemic inflammation should not be treated with antibiotics. For mild, uncomplicated, and non-purulent cases of acute diverticulitis, symptomatic treatment, IV