Benini Bruno, Scocchera Francesco, Giorgiano Fabio, Manfroni Stefano, Cataldi Carlo, Antonellis Donato
Unità Operativa Complessa di Chirurgia Generale, d'Urgenza ed Elezione, Azienda Ospedaliera San Camillo-Forlanini, Roma.
Chir Ital. 2008 Sep-Oct;60(5):745-8.
The authors present a case of midgut perforated diverticulitis in a 78-year-old patient, associated with a colovesical fistula and sigmoid obstruction of diverticular origin. Surgical resection of the small bowel segment affected together with primary anastomosis is the preferred treatment in patients with symptomatic complicated jejunoileal diverticular disease. In complicated midgut diverticulitis the preoperative diagnosis is a challenge: the symptoms are aspecific and imaging techniques are of no use. As a result, the diagnosis of complicated jejunoileal diverticulitis can be quite difficult, and a definitive diagnosis may often be made only after surgical exploration.
作者报告了一例78岁患者的中肠穿孔性憩室炎,伴有结肠膀胱瘘和憩室源性乙状结肠梗阻。对于有症状的复杂性空肠回肠憩室病患者,手术切除受影响的小肠段并进行一期吻合是首选治疗方法。在复杂性中肠憩室炎中,术前诊断是一项挑战:症状不具特异性,影像学检查无用。因此,复杂性空肠回肠憩室炎的诊断可能相当困难,往往只有在手术探查后才能做出明确诊断。