结肠憩室病的临床表现。

Clinics in gastroenterology Pub Date : 1986-10-01
W G Thompson, D G Patel
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引用次数: 0

摘要

无并发症的憩室病通常无症状。当出现与排便有关的腹痛或不适、排便习惯改变和胀气时,它们很可能是肠道易激共存的结果。尽管如此,憩室仍容易引起严重的并发症。憩室出血可能是大量的,需要急诊血管造影和节段性切除术。憩室破裂时发生憩室周围炎,可能是由于浓缩的粪便物质。这通常发生在乙状结肠,导致憩室周围脓肿被邻近的脂肪和肠系膜所局限。如果感染超出此范围,则可能发生脓肿、瘘管或游离穿孔。这些并发症需要抗生素和静脉注射治疗,在无法控制的脓肿或穿孔的情况下,需要紧急手术。结肠梗阻,有时伴有肠梗阻,在这种情况下,在广泛憩室疾病中可能发现癌。虽然没有足够的证据证明高纤维饮食适用于普通人群,但在治疗无并发症的憩室疾病时采用低残留饮食的观念应该被搁置。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical picture of diverticular disease of the colon.

Uncomplicated diverticular disease is usually asymptomatic. When abdominal pain or discomfort related to defecation, altered bowel habit, and flatulence occur, they are likely a result of a coexistent irritable bowel. Nonetheless, diverticula are subject to serious complications. Diverticular hemorrhage may be massive and require emergency angiography and segmental resection. Peridiverticulitis occurs when a diverticulum ruptures, perhaps because of inspissated fecal material. This occurs usually in the sigmoid, resulting in a peridiverticular abscess localized by the adjacent fat and mesentery. If the infection extends beyond this, abscess, fistula, or free perforation may occur. These complications require antibiotics, intravenous therapy, and, in the case of uncontrollable abscess or perforation, urgent surgery. Obstruction of the colon, sometimes associated with ileus, may occur and in this case one may find a carcinoma among extensive diverticular disease. Although there is insufficient evidence to justify a high-fiber diet for the general population, the notion of a low-residue diet in the management of uncomplicated diverticular disease should be laid to rest.

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