Herfarth C, Klar E
Langenbecks Arch Chir. 1986;369:311-20. doi: 10.1007/BF01274381.
Colorectal perforation per se requires surgical intervention whereas in lower gastrointestinal bleeding localisation of the bleeding point has priority to any therapeutic action. Among the prevailing diagnostic methods coloscopy was found to be clinically most relevant. In profuse bleeding or for the interval detection of angiodysplasia angiography is the means of first choice. Subtotal colectomy has proved advantageous, if resection is necessitated without localisation of the bleeding site. The present operative concept in colonic perforation implies the primary excision of the lesion in diverticular as well as in neoplastic disease.
结直肠穿孔本身需要手术干预,而在下消化道出血时,出血点的定位比任何治疗措施都更为重要。在常用的诊断方法中,结肠镜检查在临床上被认为是最相关的。对于大量出血或间歇性血管发育异常的检测,血管造影是首选方法。如果必须在未定位出血部位的情况下进行切除,结肠次全切除术已被证明是有利的。目前结肠穿孔的手术理念是对憩室病和肿瘤性疾病的病变进行一期切除。