Department of Surgery, Okinawa Prefectural Chubu Hospital, 281 Miyazato, Uruma, Okinawa, 904-2293, Japan.
Surg Today. 2010 Apr;40(4):321-5. doi: 10.1007/s00595-008-4055-5. Epub 2010 Mar 26.
Right-sided diverticulitis is a rare clinical entity in Western countries; however, in some Asian countries diverticulitis affects the right side of the colon more often than the left side. This study aims to establish some guidelines for patients with right-sided diverticulitis because at present, there are only guidelines for those with acute left-sided diverticulitis.
A review was conducted of the medical records of patients with acute right-sided diverticulitis admitted to Okinawa Prefectural Chubu Hospital, a teaching hospital in Japan, between 1994 and 2005.
Right-sided diverticulitis was identified in 110 patients. The mean age of these patients was significantly lower than that of those with left-sided diverticulitis (43.4 +/- 14.8 years vs 54.8 +/- 17.4 years, respectively). Emergency laparotomy was performed for suspected acute appendicitis in 10 patients. Initial conservative therapy did not fail in any of the remaining 100 patients, although 5 underwent subsequent elective surgery, and 8 (8.4%) of the remaining 95 suffered recurrent right-sided diverticulitis, which was treated successfully with conservative therapy.
Patients with acute right-sided diverticulitis seldom require emergency surgery unless acute appendicitis is misdiagnosed preoperatively. Most cases of uncomplicated right-sided diverticulitis, even if it is recurrent, can be treated conservatively.
右半结肠炎在西方国家是一种罕见的临床实体；然而，在一些亚洲国家，结肠炎更常影响右侧结肠而不是左侧。本研究旨在为右侧结肠炎患者制定一些指南，因为目前只有急性左侧结肠炎的指南。
回顾性分析了 1994 年至 2005 年期间在日本冲绳县中部医院（一所教学医院）就诊的急性右侧结肠炎患者的病历。
发现 110 例右侧结肠炎。这些患者的平均年龄明显低于左侧结肠炎患者（分别为 43.4 +/- 14.8 岁和 54.8 +/- 17.4 岁）。10 例患者因疑似急性阑尾炎而行急诊剖腹手术。其余 100 例患者初始保守治疗均未失败，尽管其中 5 例随后行择期手术，95 例中 8 例（8.4%）发生复发性右侧结肠炎，经保守治疗成功治疗。
除非术前误诊为急性阑尾炎，否则急性右侧结肠炎患者很少需要急诊手术。大多数单纯性右侧结肠炎病例，即使反复发作，也可以保守治疗。
