Tagart R E
Ann R Coll Surg Engl. 1974 Oct;55(4):175-83.
The very varied pathology which underlies peritonitis caused by colonic diverticular disease makes the comparison of various methods of treatment very difficult. The best results are probably achieved by removal of the affected part of the colon from the abdomen as soon as possible. Really aggressive medical treatment is an essential accompaniment to any form of surgery. A two-stoma or Hartmann procedure is generally the safest form of resection. Immediate anastomosis has no particular advantage since it should always be accompanied by a proximal diverting colostomy, making a second operation necessary in any case. In desperate cases proximal colostomy may be the only possible procedure and can be life-saving. The advantage of a skin-bridge colostomy is stressed.In cases of haemorrhage the source of bleeding is usually impossible to locate. Conservative treatment is successful in most cases, but if there is no alternative to surgery subtotal colectomy with ileorectal anastomosis is the treatment of choice.
由结肠憩室病引起的腹膜炎所具有的极为多样的病理状况使得对各种治疗方法进行比较变得非常困难。通过尽快从腹部切除结肠的患病部分可能会取得最佳效果。积极的药物治疗对于任何形式的手术来说都是必不可少的辅助手段。双造口术或哈特曼手术通常是最安全的切除方式。即时吻合术没有特别的优势，因为它始终需要同时进行近端转流性结肠造口术，无论如何都需要进行二次手术。在绝望的情况下，近端结肠造口术可能是唯一可行的手术方式，且可能挽救生命。强调了皮肤桥接结肠造口术的优势。在出血的情况下，出血源通常难以定位。大多数情况下保守治疗是成功的，但如果除手术外别无选择，回肠直肠吻合术的结肠次全切除术是首选的治疗方法。
