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升结肠憩室炎的管理:十年经验

Management of diverticulitis of the ascending colon. 10 years' experience.

作者信息

Gouge T H, Coppa G F, Eng K, Ranson J H, Localio S A

出版信息

Am J Surg. 1983 Mar;145(3):387-91. doi: 10.1016/0002-9610(83)90208-8.

Abstract

Diverticulitis of the ascending colon is an uncommon disease which mimics appendicitis. The correct diagnosis is rarely made, but can be suggested by the patterns of signs and symptoms and confirmed by barium contrast study. Diverticulitis of the ascending colon should be treated by the same plan as diverticulitis of the left colon. If the diagnosis is established, nonoperative management is indicated initially. Operation is indicated when the diagnosis is in doubt, when perforation has occurred, or when the patient does not respond to nonoperative treatment. At operation, ascending colon diverticulitis can be recognized as an inflammatory mass involving the wall and mesentery of the colon. The inflammatory mass is best treated by resection with primary anastomosis of the ileum to the ascending or transverse colon in an area removed from the site of infection.

摘要

升结肠憩室炎是一种罕见的疾病,酷似阑尾炎。正确诊断很少能做出,但可通过体征和症状模式提示,并通过钡剂造影检查确诊。升结肠憩室炎应采用与左结肠憩室炎相同的治疗方案。如果确诊,最初应采取非手术治疗。当诊断存疑、发生穿孔或患者对非手术治疗无反应时,则需手术治疗。手术时,升结肠憩室炎可表现为累及结肠壁和肠系膜的炎性肿块。对于炎性肿块,最好的治疗方法是在远离感染部位切除后,将回肠与升结肠或横结肠进行一期吻合。

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