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頁籤選單縮合
題名 | Diverticular Disease of the Colon=大腸憇室症 |
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作者姓名(中文) | 邱仁輝; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 20:2 1987.03[民76.03] |
頁次 | 頁102-108 |
分類號 | 416.245 |
關鍵詞 | 大腸憩室症; |
語文 | 英文(English) |
中文摘要 | 大腸憩室症被認為是食物中缺乏纖維素引致的疾病。在西方國家大多侵犯左側大腸(降結腸、乙狀結腸或脾曲部)。但是在遠東地區則多侵犯右側大屬(升結腸、盲腸或肝曲部)。台北榮民總醫院在最近六年中共有105例接受治療,60%為右側、28%為左側,12%則侵犯全部大腸。臨床表徵包括憩室炎、出血、大腸功能失調、無症狀和合併有併發症。治療原則以保守性療法為主,手術治療則針對有合併症者如發炎、出血、腸阻塞或是合併有瘻管。右側憩室炎常被誤診為急性闌尾炎(46.1%)。萬一急診剖腹探查為憩室炎時,我們建議作闌尾切除術;若有阻塞現象或疾病部位無法與惡性瘤區分時,再作病灶切除術。 |
英文摘要 | One hundred and five patients with colonic diverticular disease were treated in Veterans General Hospital, Taipei, from 1980 through 1985. Of these patients, sixty percent had right-sided involvement, twenty eight percent left-sided, and twelve percent involved the entire colon. The average age of the patients with right-sided involvement was 54.3 years, which was 12.6 years younger than that of the patients with left-sided disease, and 18.2 year younger than that of patients with entire colon involvement. Clinical manifestations included inflammation with or without complications (33.3%), bleeding (20%), disturbed bowel function (23.8%) and symptomless (22.9%). The first impression of acute appendicitis was made in 11.4% of the total 105 patients (12/105)and in 46.1% of the patients with rightsided diverticulitis (12/26). Surgical treatments included diverticulectomy or resection of diseased colon for the nonperforated diverticula, diverting colostomy with drainage or Hartmann's procedure for the perforated diverticula, and subtotal colectomy with anastomosis for unlocated bleeding of the colon. We concluded that diverticular disease of the colon could be successfully treated medically. Surgery is indicated in repeated inflammation, recurrent bleeding, perforation, obstruction and fistula formation. Once explored by emergency procedure forright-sided diverticulitis, supplementary appendectomy is suggested, while resection is reserved for obstruction of the bowel and inflammatory mass undifferentiated from carcinoma. |
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