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憩室病患者何时进行结肠镜检查及原因:个性化方法

When to Perform a Colonoscopy in Diverticular Disease and Why: A Personalized Approach.

作者信息

Tursi Antonio, Papa Valerio, Lopetuso Loris Riccardo, Vetrone Lorenzo Maria, Gasbarrini Antonio, Papa Alfredo

机构信息

Territorial Gastroenterology Service, ASL BAT, 70031 Andria, Italy.

Department of Translational Medicine and Surgery, School of Medicine, Catholic University, 00168 Rome, Italy.

出版信息

J Pers Med. 2022 Oct 14;12(10):1713. doi: 10.3390/jpm12101713.

Abstract

Colonoscopy is a crucial diagnostic tool in managing diverticular disease (DD). Diverticulosis can often be an unexpected diagnosis when colonoscopy is performed in asymptomatic subjects, generally for colorectal cancer screening, or it could reveal an endoscopic picture compatible with DD, including acute diverticulitis, in patients suffering from abdominal pain or rectal bleeding. However, alongside its role in the differential diagnosis of colonic diseases, particularly with colon cancer after an episode of acute diverticulitis or segmental colitis associated with diverticulosis, the most promising use of colonoscopy in patients with DD is represented by its prognostic role when the DICA (Diverticular Inflammation and Complication Assessment) classification is applied. Finally, colonoscopy plays a crucial role in managing diverticular bleeding, and it could sometimes be used to resolve other complications, particularly as a bridge to surgery. This article aims to summarize "when" to safely perform a colonoscopy in the different DD settings and "why".

摘要

结肠镜检查是管理憩室病(DD)的关键诊断工具。当在无症状受试者中进行结肠镜检查时,通常是为了进行结直肠癌筛查,憩室病往往可能是意外诊断结果;或者在患有腹痛或直肠出血的患者中,结肠镜检查可能会发现与憩室病相符的内镜图像,包括急性憩室炎。然而,除了在结肠疾病鉴别诊断中的作用,特别是在急性憩室炎发作后或与憩室病相关的节段性结肠炎后与结肠癌的鉴别诊断中,当应用DICA(憩室炎和并发症评估)分类时,结肠镜检查在憩室病患者中最有前景的用途体现在其预后作用上。最后,结肠镜检查在处理憩室出血方面起着关键作用,有时还可用于解决其他并发症,特别是作为手术的桥梁。本文旨在总结在不同憩室病情况下安全进行结肠镜检查的“时机”以及“原因”。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a940/9605603/5b8057f9b594/jpm-12-01713-g001.jpg

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