Akhrass R, Yaffe M B, Fischer C, Ponsky J, Shuck J M
Department of Surgery, University Hospitals of Cleveland, OH 44106, USA.
J Am Coll Surg. 1997 Apr;184(4):383-8.
Small-bowel diverticulosis is a rare entity that can be discovered incidentally during celiotomy, endoscopy, or radiographic imaging studies. The reported complication rate is low, giving rise to the current recommendation not to treat uncomplicated small-bowel diverticula.
A retrospective review was performed of patients with small-bowel diverticulosis seen during 23 years at three major institutions.
Two hundred eight patients were identified. Diverticula were located in the duodenum in 79 percent; in the jejunum or ileum in 18 percent; and in duodenum, jejunum, and ileum in 3 percent. Complications developed in 42 of the 208 patients (20 percent) including bleeding in 14, diverticulitis with perforation and abscess formation in 12, and malabsorption in 8. When assessed by location, jejunoileal diverticula were more likely to have complications than duodenal diverticula: 46 percent compared to 13 percent (p < .01). Bleeding accounted for 52 percent of the duodenal complications compared to 12 percent of the jejunoileal complications (p < 05). Jejunoileal diverticula were more likely to perforate and develop abscesses (21 percent compared to 1.2 percent; p < .001).
The low incidence of complications associated with duodenal diverticula justifies a nonoperative approach. The higher complication rate associated with jejunoileal diverticula will be necessary to define that approach more exactly.
小肠憩室病是一种罕见病症，可在剖腹术、内镜检查或放射影像学研究中偶然发现。据报道其并发症发生率较低，因此目前建议对无并发症的小肠憩室不予治疗。
对三大机构23年间收治的小肠憩室病患者进行回顾性研究。
共确定208例患者。憩室位于十二指肠的占79%；位于空肠或回肠的占18%；位于十二指肠、空肠和回肠的占3%。208例患者中有42例（20%）出现并发症，其中14例出血，12例憩室炎伴穿孔和脓肿形成，8例吸收不良。按位置评估，空回肠憩室比十二指肠憩室更易发生并发症：分别为46%和13%（p < .01）。十二指肠并发症中出血占52%，而空回肠并发症中出血占12%（p < 05）。空回肠憩室更易穿孔并形成脓肿（分别为21%和1.2%；p < .001）。
十二指肠憩室相关并发症的低发生率证明非手术治疗方法是合理的。空回肠憩室较高的并发症发生率将有必要更确切地确定该治疗方法。
