Uwechue R U, Richards E R, Kurer M
Scarborough General Hospital, Woodlands Drive, Scarborough, North Yorkshire YO12 6QL, UK.
Ann R Coll Surg Engl. 2012 Nov;94(8):e235-6. doi: 10.1308/003588412X13373405387131.
Caecal diverticulitis is an uncommon phenomenon in western countries. The clinical diagnosis is often difficult as it mimics other acute abdominal conditions like appendicitis, colitis or neoplasia. Diagnosis is often made at operation. Operative strategy has been controversial and there is no broad consensus emerging. We report the case of a 71-year-old woman, known to have chronic obstructive pulmonary disease, who presented acutely with right iliac fossa pain. A clinical diagnosis of appendicitis was made. At laparoscopy, a solitary, inflamed, gangrenous caecal diverticulum was found. A laparoscopic stapled diverticulectomy was performed. The patient made a steady post-operative recovery. Histology confirmed diverticulitis. We conclude that stapled diverticulectomy for solitary caecal diverticulitis is a safe and effective surgical strategy when confronted with this scenario.
盲肠憩室炎在西方国家是一种罕见现象。临床诊断往往困难,因为它酷似其他急性腹部疾病,如阑尾炎、结肠炎或肿瘤。诊断通常在手术时做出。手术策略一直存在争议,尚未形成广泛共识。我们报告一例71岁女性病例,该患者患有慢性阻塞性肺疾病,因右下腹疼痛急性就诊。临床诊断为阑尾炎。腹腔镜检查时,发现一个孤立的、发炎的、坏疽性盲肠憩室。实施了腹腔镜吻合器憩室切除术。患者术后恢复平稳。组织学检查证实为憩室炎。我们得出结论,对于孤立性盲肠憩室炎,吻合器憩室切除术是面对这种情况时一种安全有效的手术策略。