Ryan P
Colorectal Clinic, St Vincent's Hospital, Melbourne, Australia.
Ann R Coll Surg Engl. 1991 Mar;73(2):73-9.
Two kinds of acquired diverticular disease were identified. The more common variety presented with pain, bowel symptoms or fistulae, and the less common with bleeding. The former patients rarely had a history of bleeding and among the latter pain and bowel symptoms were uncommon. In contrast to the few, chiefly sigmoid, diverticular often found in the former group, barium enemas of those presenting with bleeding usually showed densely packed and extensive diverticula. Even where there was no history suggesting perforation or evidence of it at operation, specimens resected for the more common form of diverticular disease invariably showed histological evidence of previous perforation. There was no histological evidence of previous perforation in those specimens resected for bleeding. This retrospective clinical, radiological and histological study supported the idea that there are two kinds of diverticular disease, one associated with perforation and its sequelae, the other associated with bleeding.
确认了两种后天性憩室病。较常见的一种表现为疼痛、肠道症状或瘘管，较不常见的则表现为出血。前一组患者很少有出血史，而后一组中疼痛和肠道症状并不常见。与前一组中常发现的少数主要位于乙状结肠的憩室不同，有出血症状患者的钡灌肠检查通常显示憩室密集且广泛。即使没有提示穿孔的病史或手术中也未发现穿孔证据，为较常见形式的憩室病切除的标本总是显示有先前穿孔的组织学证据。为出血而切除的标本中没有先前穿孔的组织学证据。这项回顾性临床、放射学和组织学研究支持了这样一种观点，即存在两种憩室病，一种与穿孔及其后遗症相关，另一种与出血相关。
