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获得性空肠回肠憩室病及其并发症:文献综述

Acquired jejunoileal diverticulosis and its complications: a review of the literature.

作者信息

Woods Kevin, Williams Eric, Melvin Willie, Sharp Kenneth

机构信息

Vanderbilt University Medical Center, Nashville, Tennessee 37232-2577, USA.

出版信息

Am Surg. 2008 Sep;74(9):849-54.

Abstract

Jejunoileal diverticulosis is a rare entity. Jejunoileal diverticulosis is not a disease that surgeons see often in clinical practice; however, it should remain on the differential diagnosis for any patient with an acute abdomen or gastrointestinal bleeding of unknown origin. It can present with a wide range of clinical scenarios and when patients experience chronic symptoms such as bloating, abdominal pain, nausea, bacterial overgrowth, or malabsorption, medical therapy is successful in most patients. However, when patients present with acute symptoms of bleeding, inflammation, perforation, or obstruction, surgical resection and primary anastomosis is often the treatment of choice. If patients are asymptomatic, they are better left alone, even when discovered incidentally in the operating room. In closing, the possibility of a patient having jejunal diverticular disease should be suspected whenever the symptoms of obscure abdominal pain, anemia, dilated jejunal loops on abdominal radiographs, a history of colonic diverticuli, and a history of acute appendicitis.

摘要

空肠回肠憩室病是一种罕见的病症。空肠回肠憩室病并非外科医生在临床实践中常见的疾病;然而,对于任何患有急腹症或不明原因胃肠道出血的患者,它都应保留在鉴别诊断范围内。它可呈现出广泛的临床情况,当患者出现诸如腹胀、腹痛、恶心、细菌过度生长或吸收不良等慢性症状时,大多数患者通过药物治疗会取得成功。然而,当患者出现出血、炎症、穿孔或梗阻等急性症状时,手术切除并一期吻合术通常是首选的治疗方法。如果患者无症状,即便在手术室偶然发现,也最好不予处理。总之,只要出现不明原因的腹痛、贫血、腹部X光片显示空肠袢扩张、有结肠憩室病史以及急性阑尾炎病史等症状,就应怀疑患者患有空肠憩室病的可能性。

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