Which procedure should not be performed in the case of acute diverticulitis?

In the context of acute diverticulitis, colonoscopy should not be performed due to the risk of perforation. During an acute episode, the diverticula (small pouches formed in the colon wall) can be inflammatory or even infected, and inserting a colonoscope can cause damage to an already weakened area, potentially leading to complications such as perforation, which can result in peritonitis and require surgical intervention.

Diagnostic imaging techniques such as CT scans and ultrasounds are preferred as they help confirm the diagnosis of diverticulitis without the associated risks of invasive procedures. A CT scan, in particular, is commonly used because it provides detailed images that can illustrate the extent of inflammation or complications related to diverticulitis. Ultrasound can also be useful, especially in certain populations (such as young adults or pregnant women) where radiation exposure from a CT scan could be a concern. X-rays are less helpful in diagnosing diverticulitis specifically but can be used to evaluate for complications such as perforation or obstruction.

Therefore, the avoidance of colonoscopy in acute diverticulitis is crucial to prevent further complications in a patient already experiencing an inflammatory process in the colon.