1 Department of Surgery, University of North Carolina, Chapel Hill, North Carolina 2 Division of Gastrointestinal Surgery, University of North Carolina, Chapel Hill, North Carolina.
Dis Colon Rectum. 2019 Oct;62(10):1153-1156. doi: 10.1097/DCR.0000000000001457.
A healthy 65-year-old woman presents to the emergency department with a 12-hour history of sudden-onset severe lower abdominal pain. This is her first episode. She reports nausea, vomiting, and anorexia. Her last colonoscopy was at age 60, and was normal, except for diverticulosis of the sigmoid colon. Physical examination is significant for fever, tachycardia, and generalized abdominal pain with rebound tenderness. Pertinent laboratory findings include a leukocytosis and metabolic acidosis. A CT scan is obtained and is consistent with freely perforated diverticulitis, including a thickened sigmoid colon, free fluid in the pelvis, and free air noted near the diaphragm (). The surgeon completes the patient evaluation, recommends initiation of intravenous fluid resuscitation and antibiotics, and plans to go immediately to the operating room for surgical resection.
一位健康的 65 岁女性因突发剧烈下腹痛 12 小时就诊于急诊科。这是她第一次发作。她报告有恶心、呕吐和食欲不振。她最后一次结肠镜检查是在 60 岁时，除了乙状结肠憩室病外，一切正常。体格检查显示发热、心动过速和全腹疼痛伴反跳痛。相关实验室检查结果包括白细胞增多和代谢性酸中毒。进行 CT 扫描，结果与自由穿孔性憩室炎一致，包括乙状结肠增厚、盆腔游离液和膈肌附近有游离气体（）。外科医生完成了患者评估，建议开始静脉补液和抗生素治疗，并计划立即去手术室进行手术切除。
