对憩室病诊断进展的批判性评价。
A critical appraisal of advances in the diagnosis of diverticular disease.
机构信息
a Gastroenterology Service , ASL BAT , Andria , Italy.
出版信息
Expert Rev Gastroenterol Hepatol. 2018 Aug;12(8):791-796. doi: 10.1080/17474124.2018.1487288. Epub 2018 Jun 19.
Diverticulosis of the colon is a common condition, and about one-fourth of those people develop symptoms, which is called 'diverticular disease' (DD). Since there are still some concerns about the diagnosis of DD, the aim of this review was to analyze current and evolving advances in its diagnosis. Area covered: Analysis of clinical, radiology, laboratory, and endoscopic tools to pose a correct diagnosis of DD was performed according to current PubMed literature. Expert commentary: A combination of clinical characteristic of the abdominal pain and fecal calprotectin expression may help to differentiate between symptomatic uncomplicated diverticular disease and irritable bowel syndrome. Abdominal computerized tomography (CT) scan is still the gold standard in diagnosing acute diverticulitis and its complications. CT-colonography may be useful as a predicting tool on the outcome of the disease. Diverticular Inflammation and Complications Assessment (DICA) endoscopic classification shows a significant relationship between severity of DICA score inflammatory indexes, as well as with severity of abdominal pain. Moreover, it seems to be predictive of the outcome of the disease in terms of acute diverticulitis occurrence/recurrence and surgery occurrence. Finally, preliminary data found intestinal microbiota analysis is a promising tool in diagnosing and monitoring this disease.
结肠憩室病是一种常见病症,其中约有四分之一的患者会出现症状,这种情况被称为“憩室病”(DD)。由于对 DD 的诊断仍存在一些担忧,因此本次综述的目的是分析其诊断方面的当前和不断发展的进展。
涵盖领域
根据当前的 PubMed 文献,对临床、影像学、实验室和内镜工具进行分析,以做出正确的 DD 诊断。
专家评论
腹痛的临床特征和粪便钙卫蛋白表达的组合可能有助于区分有症状的单纯性憩室病和肠易激综合征。腹部计算机断层扫描(CT)仍然是诊断急性憩室炎及其并发症的金标准。CT 结肠成像术可能作为疾病结果的预测工具有用。憩室炎和并发症评估(DICA)内镜分类显示 DICA 评分炎症指标的严重程度以及腹痛的严重程度之间存在显著关系。此外,它似乎可以预测急性憩室炎的发生/复发以及手术的发生。最后,初步数据发现肠道微生物组分析是诊断和监测这种疾病的有前途的工具。