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[小肠憩室——诊断与并发症]

[Small bowel diverticula – diagnosis and complications].

作者信息

Bach A G, Lübbert C, Behrmann C, Surov A

机构信息

Klinik für Diagnostische Radiologie, Martin-Luther-Universität Halle-Wittenberg, Halle.

出版信息

Dtsch Med Wochenschr. 2011 Jan;136(4):140-4. doi: 10.1055/s-0031-1272497. Epub 2011 Jan 18.

Abstract

Aquired diverticula of the small bowel (not Meckel?s diverticulum) have a prevalence of 1 to 5 % and are relatively common. They are usually asymptomatic. However, in rare cases they can cause unspecific abdominal symptoms and even critical complications that require surgical intervention. Patients with diverticula of the small bowel were selected from all patients treated at an university hospital of maximal care in a retrospective study covering nine years. In 72 patients with diverticula, 47 % were asymptomatic, 47 % had unspecific abdominal symptoms and 6 % presented acute complications. In 83 % diverticula were localised in the duodenum and proximal jejunum. More distal parts of the small intestine were affected with decreasing frequency. A disseminated affection of the entire small bowel was found in 4 % of all patients. Diagnosis was made by endoscopic techniques in most cases (87 %) and to a smaller extent by CT- and MR-imaging and by other methods. The pattern of complications found is similar to earlier studies. Endoscopic techniques have replaced enteroclysis as the most widespread diagnostic technique in diagnosis of small bowel diverticula.

摘要

获得性小肠憩室(非梅克尔憩室)的患病率为1%至5%,相对常见。它们通常无症状。然而,在罕见情况下,它们可引起非特异性腹部症状,甚至导致需要手术干预的严重并发症。在一项为期九年的回顾性研究中,从一家大学重症监护医院接受治疗的所有患者中选取了患有小肠憩室的患者。在72例患有憩室的患者中,47%无症状,47%有非特异性腹部症状,6%出现急性并发症。83%的憩室位于十二指肠和空肠近端。小肠更远端部分受影响的频率逐渐降低。在所有患者中,4%发现整个小肠弥漫性受累。大多数情况下(87%)通过内镜技术进行诊断,较小程度上通过CT和磁共振成像以及其他方法进行诊断。发现的并发症模式与早期研究相似。内镜技术已取代小肠灌肠造影,成为诊断小肠憩室最广泛应用的诊断技术。

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