Roth T, Demartines N, Gavelli A, Huguet C
Département de chirurgie viscérale, centre hospitalier Princesse Grace, Monaco, Principauté de Monaco.
Chirurgie. 1999 Jun;124(3):307-12. doi: 10.1016/s0001-4001(99)80098-1.
Giant diverticulum of the colon is a rare complication of the colonic diverticulosis. It generally involves the sigmoid colon. In the chronic form, without symptoms or with only a few non-specific symptoms, an abdominal mass is frequently palpable. A plain abdominal radiogram, showing a gas-filled cyst, can suggest the diagnosis. If needed, an abdominal CT scan is appropriate and seems to be more accurate than a barium enema. The treatment of choice is a segmental resection of the colon involving the giant diverticulum, followed by a direct anastomosis. Despite the old age of these patients, both postoperative morbidity and mortality are low and justify such a radical approach. The acute clinical presentation (about 20%) is generally due to a peritonitis by perforation of the giant diverticulum and requires an emergency colectomy.
结肠巨大憩室是结肠憩室病的一种罕见并发症。它通常累及乙状结肠。在慢性形式中，无症状或仅有少数非特异性症状，常可触及腹部肿块。腹部平片显示气囊肿可提示诊断。如有必要，腹部CT扫描是合适的，且似乎比钡灌肠更准确。首选的治疗方法是切除包含巨大憩室的结肠段，然后进行直接吻合。尽管这些患者年龄较大，但术后发病率和死亡率都很低，这种根治性方法是合理的。急性临床表现（约20%）通常是由于巨大憩室穿孔引起的腹膜炎，需要紧急行结肠切除术。
