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后天性空肠回肠憩室的临床意义。

The clinical significance of acquired jejunoileal diverticula.

作者信息

de Bree E, Grammatikakis J, Christodoulakis M, Tsiftsis D

机构信息

Department of Surgical Oncology, University of Crete-Medical School, Herakleion, Greece.

出版信息

Am J Gastroenterol. 1998 Dec;93(12):2523-8. doi: 10.1111/j.1572-0241.1998.00605.x.

Abstract

OBJECTIVE

Because of the relative rarity of acquired jejunoileal diverticulosis, including its symptomatology and complications, diagnosis is often difficult and delayed, resulting in unnecessary morbidity and mortality. The purpose of the present study was to draw attention to jejunoileal diverticula and their complications as a site of gastrointestinal symptoms.

METHODS

The records of 10 patients with symptomatic jejunoileal diverticula treated in our departments were reviewed.

RESULTS

The clinical presentation was varying and nonspecific. Jejunoileal diverticula were diagnosed peroperatively in four patients operated on successfully for their acute complications. In one case the diagnosis was considered after a radiotargeted erythrocyte bleeding scan and in five other cases enteroclysis for chronic abdominal complaints demonstrated jejunoileal diverticula. The death of one patient operated on for massive hemorrhage from jejunal diverticula was probably related to delayed diagnosis and treatment.

CONCLUSIONS

Jejunoileal diverticula should not always be dismissed as asymptomatic findings, as they may be the cause of vague, chronic symptomatology and acute complications, including intestinal obstruction, hemorrhage, and perforation. Awareness of the fact that jejunoileal diverticula may cause chronic nonspecific abdominal symptoms and serious acute complications may lead to earlier diagnosis and timely treatment with lower morbidity and mortality.

摘要

目的

由于获得性空肠回肠憩室病相对少见,包括其症状学和并发症,诊断往往困难且延迟,导致不必要的发病和死亡。本研究的目的是引起人们对空肠回肠憩室及其并发症作为胃肠道症状发生部位的关注。

方法

回顾了在我们科室接受治疗的10例有症状的空肠回肠憩室患者的记录。

结果

临床表现多样且无特异性。4例因急性并发症成功接受手术的患者在术中诊断为空肠回肠憩室。1例在放射性靶向红细胞出血扫描后考虑诊断,另外5例因慢性腹部不适进行小肠灌肠造影显示有空肠回肠憩室。1例因空肠憩室大出血接受手术的患者死亡,可能与诊断和治疗延迟有关。

结论

空肠回肠憩室不应总是被视为无症状表现,因为它们可能是模糊的慢性症状和急性并发症(包括肠梗阻、出血和穿孔)的原因。认识到空肠回肠憩室可能导致慢性非特异性腹部症状和严重急性并发症这一事实,可能会导致更早的诊断和及时的治疗,从而降低发病率和死亡率。

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