Neylan Christopher J, Kim Alyson, Amy Maya, Hernandez Paul T
Department of Surgery, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania.
Department of Surgery, Temple University Hospital, Temple University, Philadelphia, Pennsylvania.
Clin Colon Rectal Surg. 2024 Oct 4;38(4):241-248. doi: 10.1055/s-0044-1791282. eCollection 2025 Jul.
Diverticular disease consists of diverticulosis and diverticulitis. Diverticulosis is commonly encountered, and approximately 4% of patients with diverticulosis will progress to develop diverticulitis, which represents a significant health care burden in the United States. Diverticular disease has an increasing incidence both in the United States and globally as important risk factors, including obesity, are becoming more prevalent. The pathophysiology of diverticular disease remains incompletely understood, although geographic and population-based differences in its prevalence and anatomic distribution have generated several hypotheses as to the impact of genetic and environmental factors on development and disease progression. Uncomplicated diverticulitis has had a low mortality rate for the last several decades, but in-hospital mortality approaches 7% for patients with complicated diverticulitis who require emergent surgery. For patients that develop diverticulitis, recent population-based data have led to an improved understanding of which patients will suffer recurrent episodes. This knowledge has facilitated informed discussions with patients and has changed practice in terms of elective surgery.
憩室病包括憩室症和憩室炎。憩室症很常见，约4%的憩室症患者会进展为憩室炎，这在美国是一个重大的医疗负担。在美国和全球，憩室病的发病率都在上升，因为包括肥胖在内的重要风险因素越来越普遍。尽管憩室病在患病率和解剖分布上存在地域和人群差异，从而产生了关于遗传和环境因素对其发生发展及疾病进展影响的几种假说，但憩室病的病理生理学仍未完全明确。在过去几十年里，非复杂性憩室炎的死亡率较低，但对于需要急诊手术的复杂性憩室炎患者，住院死亡率接近7%。对于发生憩室炎的患者，最近基于人群的数据使人们对哪些患者会复发有了更好的了解。这些知识有助于与患者进行明智的讨论，并在择期手术方面改变了临床实践。
