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中华普通外科学文献(电子版) ›› 2017, Vol. 11 ›› Issue (04) : 239 -242. doi: 10.3877/cma.j.issn.1674-0793.2017.04.006

所属专题: 经典病例 文献

论著

小肠憩室的诊断特点及外科治疗:附39例报告
王浩1, 管文贤1,()   
  1. 1. 210008 南京鼓楼医院普外科
  • 收稿日期:2016-09-23 出版日期:2017-08-01
  • 通信作者: 管文贤
  • 基金资助:
    国家自然基金资助项目(81372364)

Diagnosis and treatment of small intestine diverticulum: a report of 39 cases

Hao Wang1, Wenxian Guan1,()   

  1. 1. Department of General Surgery, Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
  • Received:2016-09-23 Published:2017-08-01
  • Corresponding author: Wenxian Guan
  • About author:
    Corresponding author: Guan Wenxian, Email:
引用本文:

王浩, 管文贤. 小肠憩室的诊断特点及外科治疗:附39例报告[J]. 中华普通外科学文献(电子版), 2017, 11(04): 239-242.

Hao Wang, Wenxian Guan. Diagnosis and treatment of small intestine diverticulum: a report of 39 cases[J]. Chinese Archives of General Surgery(Electronic Edition), 2017, 11(04): 239-242.

目的

探讨小肠憩室的临床特点、诊断与治疗方法。

方法

回顾性分析2010年1月至2015年12月南京鼓楼医院收治的39例小肠憩室患者的临床资料。

结果

39例全部接受手术治疗,其中13例行憩室切除,12例行部分切除,5例行多处切除,9例因急腹症仅做结肠部分切除。憩室直径1.0~4.0 cm,14例伴有不同程度的黏膜充血水肿、坏死,8例憩室内合并结石,4例提示有异位组织,3例憩室内有血管瘤,未发现恶变。术后患者均一期愈合出院,32例腹痛腹胀、黑便、稀便或便秘等临床症状明显缓解消退,5例症状部分缓解,2例临床症状无变化。

结论

小肠憩室的诊断主要依据肠镜、CT等方式,应根据患者全身情况、局部炎症程度以及小肠憩室的大小、多少、部位和引起并发症的严重程度来决定手术方式。

Objective

To investigate the clinical features, diagnosis and treatment of small intestine diverticulum.

Methods

Clinical data of thirty-nine cases with small intestinal diverticulum were collected and retrospectively analyzed from January 2010 to December 2015.

Results

All the 39 patients received surgical treatment, including 13 cases of diverticulum, 12 cases of partial resection, 5 cases of multiple resection, and 9 cases of partial colectomy due to acute abdomen. The diverticulum diameter was 1.0-4.0 cm; 14 cases with different degree of mucosal hyperemia, edema or necrosis; 8 cases with calculi; 4 cases showed ectopic tissues; 3 cases were found non-malignant hemangioma. All patients were healed and discharged, abdominal distension and pain, watery diarrhea or constipation and other clinical symptoms significantly relieved in 32 cases, 5 cases obtained partial remission, while no clinical changes in 2 cases.

Conclusions

The diagnosis of small intestine diverticulum is mainly based on colonoscopy and CT. The general condition of patients, local inflammation, complications and size, location and number of diverticulum affect the appropriate treatment, according to which the surgical procedures can be designed.

图1 回肠梅克尔憩室(箭头所指)
图2 回肠梅克尔憩室切开图片
图3 小肠壁局部区域见异位胃黏膜(苏木精-伊红染色,×80)
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