摘要
目的:探讨盲部憩室炎的诊断和手术方式的选择。方法:回顾性分析18例盲部憩室炎的临床资料,包块临床表现、腹部体征、辅助检查、手术方式及随访结果。结果:18例均有右下腹疼痛及右下腹压痛。术前诊断困难,仅通过钡灌肠结肠造影和结肠镜确诊各1例,误诊为急性阑尾炎12例、阑尾周围脓肿1例、回盲部肿瘤3例。憩室单发3例,多发性15例,其中2个憩室9例,3个憩室6例。单纯憩室切除9例,回盲部切除2例;右半结肠切除7例。全组患者均获治愈,无严重并发症发生。结论:盲肠憩室炎的临床特征与急性阑尾炎相似,极易误诊为急性阑尾炎等。术中应注意探查,避免遗漏病变。根据憩室具体情况决定手术方式。
Objective： To investigate the diagnosis and selection of surgical method of cecal diverticulitis.Methods： The clinical information of 18 cases of cecal diverticulitis,including presentation,physical sign,examinations,surgical procedures and results of follow-up,was analyzed retrospectively.Results： Abdominal pain and enderness in right lower quadrant presented in all cases.It was difficult to diagnose correctly before operation.Only two cases got correct diagnosis through barium enema and colonoscopy respectively,and other 16 cases were misdiagnosed as acute appendicitis（12 cases）,periappendiceal abscess（1 case） and tumor of ileocecal junction（3 cases）.Three cases had single diverticulum,and the others had multiply,including two diverticula（9 cases）,three diverticula（6 cases）.Nine patients received diverticulectomy only,2 cases received ileocecal resection,7 cases received right hemicolectomy,and 13 cases received appendectomy.All patients were cured and had no serious complications.Conclusion： The clinical characters of cecal diverticulitis are similar to acute appendicitis.It＇s usually misdiagnosed as acute appendicitis,and should be explored carefully in operation.Different surgical procedures should be chose according to the condition of diverticulum.
出处
《华西医学》
CAS
2009年第6期1375-1377,共3页
West China Medical Journal
关键词
盲肠憩室炎
急性阑尾炎
误诊
手术方式
cecal diverticulitis
acute appendititis
misdiagnosis
surgical procedure
