Pulzato Ilaria, Boero Enrico, Shaipi Elona, Cardinale Luciano
Dipartimento di Medicina interna e Specialità mediche, Di.M.I. Università degli Studi di Geniva, Viale Benedetto XV, 10, 16132, Genoa, GE, Italy.
Dipartimento di scienze Chirurgiche, Università degli Studi di Torino, Turin, Italy.
Ultrasound J. 2019 Jun 11;11(1):14. doi: 10.1186/s13089-019-0127-6.
Diverticular disease is a common disorder and its incidence increases with ageing. Pathophysiology is multifactorial. Lifestyle, including smoking, alcohol intake, decreased dietary fibres and lack of physical activity, plays a predominant role. Genetics seems also to contribute specifically for right-sided diverticular disease (RSD). The majority of the patients with diverticular disease are asymptomatic. Diverticulitis is the inflammation of the diverticula usually presenting with abdominal pain associated to nausea, vomiting, rectal bleeding, diarrhoea and fever. When the inflammation process affects the diverticula in the ascending colon, the condition represents a clinical challenge as it can be easily misdiagnosed with other acute abdominal emergencies. We reported a case of a 70-year-old female who presented to our Emergency Department (ED) with right upper quadrant pain and an initial clinical suspicion of cholecystitis. Ultrasound (US) and Computed Tomography (CT) demonstrated an anatomical variation of the sigmoid colon diverticulitis. This clinical report demonstrates that ultrasound plays a relevant part as first-step approach to the acute abdominal conditions and its accuracy increases together with other diagnostic tools such as Computer Tomography.
憩室病是一种常见疾病，其发病率随年龄增长而增加。病理生理学是多因素的。生活方式，包括吸烟、饮酒、膳食纤维摄入减少和缺乏体育活动，起主要作用。遗传学似乎也特别与右侧憩室病（RSD）有关。大多数憩室病患者无症状。憩室炎是憩室的炎症，通常表现为伴有恶心、呕吐、直肠出血、腹泻和发热的腹痛。当炎症过程影响升结肠的憩室时，这种情况是一个临床挑战，因为它很容易与其他急性腹部急症误诊。我们报告了一例70岁女性，她因右上腹疼痛就诊于我们的急诊科（ED），最初临床怀疑为胆囊炎。超声（US）和计算机断层扫描（CT）显示乙状结肠憩室炎的解剖变异。本临床报告表明，超声作为急性腹部疾病的第一步检查方法发挥着重要作用，其准确性与计算机断层扫描等其他诊断工具一起提高。
