Elfrink R J, Miedema B W
Department of Surgery, University of Missouri-Columbia School of Medicine.
Postgrad Med. 1992 Nov 1;92(6):97-8, 101-2, 105, 108 passim. doi: 10.1080/00325481.1992.11701513.
The value of a high-fiber diet in preventing and treating colonic diverticula is firmly established. Although the diagnosis of diverticulosis is usually made with colonoscopy or barium enema examination, computed tomography has become the test of choice during acute diverticulitis, when the diagnosis cannot be confidently made clinically. Recently developed surgical principles for diverticulitis include radiographically directed drainage with delayed operation for peridiverticular abscess, resection of the site of disease in patients with general peritonitis, and primary anastomosis in most cases requiring urgent intervention. Diverticulosis accompanied by abdominal pain or irregular bowel habits is by itself rarely an indication for surgery. Diverticular bleeding usually resolves spontaneously, but persistent bleeding can usually be successfully treated with segmental colectomy after localization of the bleeding site with colonoscopy or arteriography.
高纤维饮食在预防和治疗结肠憩室方面的价值已得到确证。虽然憩室病的诊断通常通过结肠镜检查或钡灌肠检查做出，但在急性憩室炎时，当临床无法明确诊断时，计算机断层扫描已成为首选检查方法。最近制定的憩室炎手术原则包括对憩室周围脓肿进行放射引导下引流并延迟手术、对弥漫性腹膜炎患者切除病变部位以及在大多数需要紧急干预的情况下进行一期吻合。伴有腹痛或排便习惯改变的憩室病本身很少是手术指征。憩室出血通常会自行缓解，但持续出血通常可在通过结肠镜检查或动脉造影确定出血部位后，通过节段性结肠切除术成功治疗。
