Frieling Thomas
Medizinische Klinik II, Klinik für Innere Medizin mit Gastroenterologie, Hepatologie, Infektiologie, Neurogastroenterologie, Gastrointestinaler Onkologie, Hämatoonkologie und Palliativmedizin, Helios Klinikum Krefeld, Lutherplatz 40, 47805, Krefeld, Deutschland.
Internist (Berl). 2021 Mar;62(3):277-287. doi: 10.1007/s00108-021-00942-0. Epub 2021 Feb 9.
The prevalence of diverticula varies depending on the location within the gastrointestinal tract. Diverticula of the esophagus, stomach and small intestine are rare, more frequent are peripapillary diverticula and colonic diverticula. Meckel diverticula can also be of relevance in adults. Diverticula have to be differentiated from intramural pseudodiverticulosis of the esophagus and bile duct cysts. An endoscopic and radiological diagnostic work-up is only necessary for symptomatic diverticula or complications. In some cases additional functional diagnostic tests, such as high-resolution esophageal manometry to detect underlying motility disorders (Zenker's diverticulum, epiphrenic diverticulum) or the hydrogen breath test to detect bacterial overgrowth in the small intestine (diverticula of the small intestine) are mandatory. Effective treatment requires the close interdisciplinary cooperation between different specialist disciplines. Therapeutic modalities include pharmacotherapy, endoscopy and surgical methods.
憩室的患病率因胃肠道内的位置而异。食管、胃和小肠的憩室很少见,乳头周围憩室和结肠憩室更为常见。梅克尔憩室在成人中也可能具有相关性。憩室必须与食管壁内假性憩室和胆管囊肿相鉴别。仅对有症状的憩室或并发症进行内镜和放射学诊断检查。在某些情况下,额外的功能诊断测试是必要的,例如用于检测潜在运动障碍(Zenker憩室、膈上憩室)的高分辨率食管测压法,或用于检测小肠细菌过度生长(小肠憩室)的氢呼气试验。有效的治疗需要不同专科之间密切的跨学科合作。治疗方式包括药物治疗、内镜检查和手术方法。