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憩室病的结肠镜检查管理

Colonoscopic management of diverticular disease.

作者信息

Fejleh M Phillip, Tabibian James H

机构信息

UCLA Gastroenterology Fellowship Program, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States.

Division of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, CA 91342, United States.

出版信息

World J Gastrointest Endosc. 2020 Feb 16;12(2):53-59. doi: 10.4253/wjge.v12.i2.53.

Abstract

Diverticula are the most common incidental finding during routine colonoscopy, and their prevalence increases with patient age. The term "diverticular disease" encompasses the range of clinical manifestations and complications that can occur with colonic diverticula, including diverticular bleeding, diverticulitis-associated strictures, and acute diverticulitis. Colonoscopy is a vital tool in the diagnosis and management of diverticular disease and can be useful in a variety of regards. In this editorial, we concisely delineate the current approach to and practices in colonoscopic management of diverticular disease. In particular, we discuss treatment options for diverticular bleeding, propose consideration of colonic stenting as a bridge to surgery in patients with diverticulitis-associated strictures, and the need for diagnostic colonoscopy following an episode of acute diverticulitis in order to rule out underlying conditions such as colonic malignancy or inflammatory bowel disease. In addition, we offer practical tips for performing safe and successful colonoscopy in patients with dense diverticulosis coli.

摘要

憩室是常规结肠镜检查中最常见的偶然发现,其患病率随患者年龄增长而增加。“憩室病”一词涵盖了结肠憩室可能出现的一系列临床表现和并发症,包括憩室出血、憩室炎相关狭窄和急性憩室炎。结肠镜检查是憩室病诊断和管理的重要工具,在多个方面都很有用。在这篇社论中,我们简要描述了目前结肠镜管理憩室病的方法和实践。特别是,我们讨论了憩室出血的治疗选择,建议考虑将结肠支架置入作为憩室炎相关狭窄患者手术的桥梁,以及急性憩室炎发作后进行诊断性结肠镜检查以排除诸如结肠恶性肿瘤或炎症性肠病等潜在疾病的必要性。此外,我们还提供了在患有密集型结肠憩室病的患者中进行安全且成功的结肠镜检查的实用技巧。

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