Carus T, Röhn D
Abteilung für Allgemein- und Bauchchirurgie, Chirurgische Klinik des Evangelischen Krankenhauses Oldenburg, Akademisches Lehrkrankenhaus der Universität Göttingen.
Langenbecks Arch Chir. 1995;380(5):288-91. doi: 10.1007/BF00184104.
Diverticulosis of the colon is common in the descending and sigmoid part; the right colon is rarely involved. Inflammation of perforation of a cecal diverticulum is an uncommon condition that mimics acute appendicitis. The correct diagnosis is mostly made after operative exploration. Four cases were surgically treated between 1994 and 1995. Because of the severe inflammation, ileocecal resection or right hemicolectomy was necessary; in one case we performed a local excision. After removal of the inflamed mass the postoperative healing was uncomplicated. A malignancy could be histologically excluded in all cases. As in sigmoid diverticulitis, early resection seems to be a safe operative therapy. Laparoscopy can show the correct diagnosis before the laparotomy is carried out. Preoperative diagnostic measures, differential diagnosis and possible surgical procedures are discussed.
结肠憩室病常见于降结肠和乙状结肠部位;右半结肠很少受累。盲肠憩室炎或穿孔是一种罕见的病症,类似急性阑尾炎。正确诊断大多在手术探查后才能做出。1994年至1995年间对4例患者进行了手术治疗。由于炎症严重,行回盲部切除术或右半结肠切除术是必要的;1例患者进行了局部切除。切除炎性肿块后,术后愈合顺利。所有病例经组织学检查均排除恶性肿瘤。与乙状结肠憩室炎一样,早期切除似乎是一种安全的手术治疗方法。腹腔镜检查可在剖腹手术前做出正确诊断。文中讨论了术前诊断措施、鉴别诊断及可能的手术方法。