Havenstrite K A, Harris J A, Rivera D E
Department of Surgery, Dwight David Eisenhower Army Medical Center, Ft. Gordon, Georgia 30905, USA.
Am Surg. 1999 Jun;65(6):578-80.
Giant colonic diverticulum is a rare complication of colonic diverticulosis. It typically occurs as a single diverticulum located on the antimesenteric border of the sigmoid colon. The most widely accepted theory for its development attributes the progressive dilation to a "ball-valve" mechanism, allowing air to enter but not to exit. Patients usually present complaining of abdominal pain and/or an abdominal mass, although they may remain asymptomatic. Physical examination reveals a tympanic abdominal mass that appears as a round radiolucency on plain radiographs and CT. Barium enema demonstrates the relationship of the diverticulum to bowel and may document communication with the colonic lumen. To alleviate symptoms and prevent complications, the recommended treatment is excision of the diverticulum in continuity with the involved colonic segment. We report a case and discuss the presentation, diagnosis, and management of giant colonic diverticulum.
巨大结肠憩室是结肠憩室病的一种罕见并发症。它通常表现为单个位于乙状结肠系膜对侧缘的憩室。其形成最被广泛接受的理论是,渐进性扩张归因于“球阀”机制,即空气可进入但无法排出。患者通常表现为腹痛和/或腹部肿块,不过也可能没有症状。体格检查可发现腹部鼓音性肿块,在平片和CT上表现为圆形透亮区。钡剂灌肠可显示憩室与肠管的关系,并可记录其与结肠腔的连通情况。为缓解症状并预防并发症,推荐的治疗方法是将憩室与受累结肠段一并切除。我们报告了一例病例,并讨论巨大结肠憩室的表现、诊断及处理。