Sarin S, Boulos P B
University College London Medical School.
Ann R Coll Surg Engl. 1994 Mar;76(2):117-20.
The immediate management of acute diverticular disease is well defined but the risk of further complications and the long-term course of the disease, after conservative or surgical treatment, is not clearly documented. Over an 8-year period, a total of 164 patients (male/female = 69/95, median age 68 years) presented with acute complications of diverticular disease and were prospectively followed up for a median of 48 months. Medical treatment of acute diverticulitis was effective in 85% of 86 patients, with a mortality of 1.3% and a recurrence rate of 2% per patient year follow-up. All 37 patients presenting with bleeding responded to conservative management without mortality and a readmission rate, with further bleeding, of 5% per patient year. Patients who required colonic resection (n = 52), either as a single or staged procedure, had a mortality of 12% but with no further admissions with complications of diverticular disease. The low risk of readmission with recurrent disease after successful conservative treatment of the acute complications of diverticular disease does not justify elective operation in this group of patients.
急性憩室病的即时处理已明确，但保守治疗或手术治疗后进一步并发症的风险及疾病的长期病程尚无明确记录。在8年期间，共有164例患者（男/女 = 69/95，中位年龄68岁）出现憩室病急性并发症，并进行了前瞻性随访，中位随访时间为48个月。86例患者中，85%的急性憩室炎患者药物治疗有效，死亡率为1.3%，随访期间每位患者每年的复发率为2%。所有37例出血患者经保守治疗均有效，无死亡病例，再入院率（因再次出血）为每位患者每年5%。需要进行结肠切除术的患者（n = 52），无论是单次手术还是分期手术，死亡率为12%，但无因憩室病并发症再次入院的情况。对于这组患者，憩室病急性并发症成功保守治疗后疾病复发再入院风险较低，因此不建议进行择期手术。
