Wood Elizabeth H, Sigman Michael M, Hayden Dana M
Division of Colon and Rectal Surgery, Loyola University Medical Center, Maywood, Illinois.
Clin Colon Rectal Surg. 2021 Mar;34(2):121-126. doi: 10.1055/s-0040-1716704. Epub 2021 Feb 24.
Diverticular disease affects a large percentage of the US population, affecting over 30% among those older than 45 years old. It is responsible for ∼300,000 hospitalizations per year in the United States and can lead to serious complications such as hemorrhage, obstruction, abscess, fistulae, or bowel perforation. 2 It is an extremely common reason for emergency room and outpatient visits and evaluations by general and colorectal surgeons. In the US, patients usually present with sigmoid diverticulitis in the setting of a normal immune system so surgeons will follow well-established practice guidelines for treatment. However, there may be special circumstances in which the management of diverticulitis is not as straightforward. In this article, we will address patients who present with multifocal disease, giant colonic diverticulum, right-sided diverticulitis, and diverticulitis in the setting of immunosuppression and hopefully provide guidance for treatment in these special circumstances.
憩室病影响着很大比例的美国人口，45岁以上人群中受影响的比例超过30%。在美国，每年约有30万人因该病住院，它可导致严重并发症，如出血、梗阻、脓肿、瘘管或肠穿孔。这是急诊室以及普通外科和结直肠外科医生进行门诊就诊和评估的极其常见的原因。在美国，患者通常在免疫系统正常的情况下出现乙状结肠憩室炎，因此外科医生会遵循既定的治疗实践指南。然而，在某些特殊情况下，憩室炎的治疗并非如此简单直接。在本文中，我们将探讨患有多灶性疾病、巨大结肠憩室、右侧憩室炎以及免疫抑制情况下的憩室炎的患者，并希望为这些特殊情况下的治疗提供指导。
