Maier K P
Akademisches Lehrkrankenhaus der Universität Tübingen, Städtische Kliniken Esslingen. kp.maier@.kliniken-es.de
Praxis (Bern 1994). 2007 Jan 31;96(5):153-7. doi: 10.1024/1661-8157.96.5.153.
Diverticular disease is a common disorder in the western world. The course of the illness is benign: At least 75% of all patients with diverticular disease remain asymptomatic life long. 10-20% develop clinical symptoms, usually painful diverticulitis. Diverticular disease is diagnosed clinically in most cases. Computed tomography (CT) has replaced contrast enema as the diagnostic procedure of choice for acute diverticulitis. Most patients with uncomplicated diverticulitis can be treated as outpatients Bowel rest, intravenous fluid therapy, broad spectrum antibiotics are treatment modelities if a patient has been hospitalized. Close follow-up is mandatory, especially in patients treated as outpatients. Failure to improve with conservative medical therapy warrants a diligent search for complications and surgical consultation. Surgery may be nessasary in a few of hospitalized patients. Commonly, the operation is performed in a single-stage procedure. Once the acute setting has passed, a colonoscopy should be electively performed to exclude competing diagnoses particularly colonic cancer.
憩室病在西方世界是一种常见疾病。该病病程呈良性:所有憩室病患者中至少75%终生无症状。10% - 20%会出现临床症状,通常是疼痛性憩室炎。大多数情况下憩室病通过临床诊断。计算机断层扫描(CT)已取代钡剂灌肠成为急性憩室炎的首选诊断方法。大多数非复杂性憩室炎患者可作为门诊患者治疗。如果患者已住院,肠道休息、静脉补液治疗、广谱抗生素是治疗方式。密切随访是必需的,尤其是对门诊治疗的患者。保守药物治疗无效时,需认真排查并发症并咨询外科医生。少数住院患者可能需要手术。通常,手术采用一期手术。一旦急性期过去,应选择性地进行结肠镜检查以排除其他竞争性诊断,尤其是结肠癌。