目的:探讨盲部憩室炎的诊断和手术方式的选择。方法:回顾性分析18例盲部憩室炎的临床资料,包块临床表现、腹部体征、辅助检查、手术方式及随访结果。结果:18例均有右下腹疼痛及右下腹压痛。术前诊断困难,仅通过钡灌肠结肠造影和结肠镜确诊各1例,误诊为急性阑尾炎12例、阑尾周围脓肿1例、回盲部肿瘤3例。憩室单发3例,多发性15例,其中2个憩室9例,3个憩室6例。单纯憩室切除9例,回盲部切除2例;右半结肠切除7例。全组患者均获治愈,无严重并发症发生。结论:盲肠憩室炎的临床特征与急性阑尾炎相似,极易误诊为急性阑尾炎等。术中应注意探查,避免遗漏病变。根据憩室具体情况决定手术方式。
Citation:
ZHANG Sui,LIU Yong,LIU Zhen,et al.. Diagnosis and Treatment of Cecal Diverticulitis. West China Medical Journal, 2009, 24(6): 1375-1377. doi:
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- 1. KEIDAR S, PAPPO I, SHPERBER Y, et al. Cecal diverticulitis: a diagnostic challenge[J]. Dig Surg,2000,17(5):504-512.
- 2. HARADA R N, WHELAN T J JR. Surgical management of cecal diverticulitis[J]. Am J Surg,1993,166(6):666-669.
- 3. FANG J F, CHEN R J, LIN B C, et al. Aggressive resection is indicated for cecal diverticulitis[J]. Am J Surg,2003,185(2):135-140.
- 4. OUDENHOVEN L F I J, KOUMANS R K J, PUYLAERT J B C M. Right colonic diverticulitis: US and CT findingsNew insights about frequency and natural history[J]. Radiology,1998,08(3):611-618.
- 5. JANG H J, LIM H K, LEE S J, et al. Acute diverticulitis of the cecum and ascending colon: Thinsection helical CT findings[J]. AJR,1999,172(3):601-604.
- 6. YANG H R, HUANG H H, WANG Y C, et al. Management of right colon diverticulitis: A 10year experience[J]. World J Surg,2006,30(10):1929–1934.
- 7. PAPAZIOGAS B, MAKRIS J, KOUTELIDAKIS I, et al. Surgical management of cecal diverticulitis: is diverticulectomy enough?[J] Int J Colorectal Dis,2005,20(1):24-27.
- 8. HILDEBRAND P, KROPP M, STELLMACHER F, et al. Surgery for rightsided colonic diverticulitis: results of a 10yearobservation period[J]. Langenbecks Arch Surg,2007,392(2):143-147.