Lux G, Langer M, Stabenow-Lohbauer U, Orth K H, Bozkurt T, Meyer M J
Städtisches Klinikum Solingen.
Fortschr Med. 1998 Mar 30;116(9):26-8, 30, 32-4.
Diverticulosis of the colon is a disease that mainly affects the elderly, presenting in 10 to 20% of this age group. The most common complication--painful diverticular disease, is usually treated conservatively with a high-fiber diet, intermittent use of antispasmodics and possibly regulation of the stools. Diagnostic differentiation is best performed using ultrasonography of the bowel wall, supplemented where necessary by computer tomography and colonoscopy (sigmoidoscopy) or, where this latter is not possible, barium enema using Gastrografin. Conservative treatment of diverticulitis with antibiotics, bowel rest, possibly including parenteral alimentation, is usually applied for three to ten days. In the absence of a response to this treatment, frequent recurrence, immunosuppression or complications (perforation, peritonitis, enterovesicular fistula), surgery is indicated.
结肠憩室病是一种主要影响老年人的疾病,在该年龄组中的发病率为10%至20%。最常见的并发症——疼痛性憩室病,通常采用高纤维饮食、间歇性使用解痉药以及可能的大便调节进行保守治疗。诊断鉴别最好通过肠壁超声检查进行,必要时辅以计算机断层扫描和结肠镜检查(乙状结肠镜检查),或者在无法进行后者的情况下,使用泛影葡胺进行钡灌肠。憩室炎的保守治疗通常采用抗生素、肠道休息,可能包括胃肠外营养,持续三至十天。如果对这种治疗无反应、频繁复发、免疫抑制或出现并发症(穿孔、腹膜炎、肠膀胱瘘),则需进行手术。