Boulos P B, Karamanolis D G, Salmon P R, Clark C G
Lancet. 1984 Jan 14;1(8368):95-6. doi: 10.1016/s0140-6736(84)90016-3.
Colonoscopy was carried out in 65 patients in whom double-contrast barium enemas for bowel symptoms had shown sigmoid diverticular disease. In 19 of these, barium enemas had shown neoplastic lesions--polyps in 17 and carcinoma in 2; but colonoscopy showed no polyps in 9 of the 17. In 1 a carcinoma not a polyp was found, and of the 2 carcinomas only 1 was confirmed. In 46 patients the barium enemas showed diverticular disease only, but colonoscopy revealed polyps in 8 and carcinoma in 3. Thus in 23 patients (35%) the barium enema was inaccurate. 13 of 20 patients with neoplasia but only 11 of 45 without had rectal bleeding, but the numbers in the two groups who had abdominal pain or change in bowel habit were similar in the two groups. Colonoscopy revealed neoplastic lesions in 20 of the 65 patients (31%), an incidence great enough to recommend routine colonoscopy in patients with symptomatic diverticular disease, especially those with rectal bleeding.
对65例因肠道症状行双重对比钡剂灌肠检查显示乙状结肠憩室病的患者进行了结肠镜检查。其中19例钡剂灌肠检查显示有肿瘤性病变——17例为息肉，2例为癌；但结肠镜检查发现17例中有9例无息肉。1例发现的是癌而非息肉，2例癌中仅1例得到证实。46例患者钡剂灌肠检查仅显示憩室病，但结肠镜检查发现8例有息肉，3例有癌。因此，23例患者（35%）钡剂灌肠检查结果不准确。20例有肿瘤的患者中有13例有直肠出血，而45例无肿瘤的患者中只有11例有直肠出血，但两组中腹痛或排便习惯改变的患者数量相似。结肠镜检查发现65例患者中有20例（31%）有肿瘤性病变，这一发生率足以建议对有症状的憩室病患者，尤其是有直肠出血的患者进行常规结肠镜检查。
