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倒置性结肠憩室:内镜检查与表现。

Inverted colonic diverticulum: An endoscopic examination and presentation.

机构信息

Department of General Surgery, Atlas University, Istanbul, Turkey.

Department of Gastroenterology, Atlas University, Istanbul, Turkey.

出版信息

J Dig Dis. 2021 Mar;22(3):152-158. doi: 10.1111/1751-2980.12972. Epub 2021 Mar 11.

Abstract

OBJECTIVE

We aimed to determine the frequency, morphological features, differential diagnosis, possible adverse events of inverted colonic diverticulum (ICD), which may be misdiagnosed as polyps.

METHODS

In all, 810 patients who underwent a colonoscopy between April 2016 and November 2019 were included in the study, and their data were evaluated retrospectively. Colonoscopic procedures were performed at a single center by the same endoscopist.

RESULTS

Among all the 810 patients, the prevalence of diverticulum was 29.58% (121/409) in men and 25.19% (n = 101/401) in women, respectively. ICD was observed in 1.73% (n = 14) of all patients, including 11 (78.57%) men (aged 63.2 ± 12.95 years [range 47-90 years]) and three women (60.3 ± 4.04 years [range 58-65 years]). Most (63.16% [12/19]) ICD lesions were localized in the sigmoid colon. And the diagnosis was confirmed by eversion using biopsy forceps in 78.95% of them. One patient developed perforation after polypectomy with hot biopsy forceps and was treated by surgical operation.

CONCLUSIONS

ICD is a common lesion that may lead to serious adverse events if misdiagnosed as polyps. Differential diagnosis of ICD is crucial during the colonoscopy.

摘要

目的

我们旨在确定倒置结肠憩室(ICD)的频率、形态特征、鉴别诊断和可能的不良事件,因为 ICD 可能被误诊为息肉。

方法

本研究共纳入 2016 年 4 月至 2019 年 11 月间在单一中心接受结肠镜检查的 810 例患者,对其数据进行回顾性评估。所有结肠镜检查均由同一位内镜医生进行。

结果

在所有 810 例患者中,男性中憩室的患病率为 29.58%(121/409),女性中为 25.19%(n=101/401)。在所有患者中,ICD 的患病率为 1.73%(n=14),包括 11 名男性(63.2±12.95 岁[范围 47-90 岁])和 3 名女性(60.3±4.04 岁[范围 58-65 岁])。大多数(63.16%[12/19])ICD 病变位于乙状结肠。其中 78.95%(12/19)通过活检钳反转来确诊。1 名患者在使用热活检钳进行息肉切除后发生穿孔,经手术治疗。

结论

ICD 是一种常见病变,如果误诊为息肉可能会导致严重的不良事件。在结肠镜检查中,ICD 的鉴别诊断至关重要。

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