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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/OL]. 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/OL]. 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)
[1]
Sallinen V, Wikström H, Victorzon M, et al. Laparoscopic versus open adhesiolysis for small bowel obstruction-a multicenter, prospective, randomized, controlled trial[J]. BMC Surg, 2014, 14(1):77-79.
[2]
Yadav G, Husain S, Shukla R, et al. A rare case of calcified enterolith presenting as subacute intestinal obstruction[J]. Indian J Surg, 2015, 77(4):327-328.
[3]
Newton RC, Penney N, Nind N, et al. Small bowel malignant melanoma presenting as a perforated jejunal diverticulum: a case report and literature review[J]. Gastroenterol Rep (Oxf), 2016, 4(1):80-83.
[4]
王峰,赵宏亮,李剑, 等. 多层螺旋CT对小肠Meckel’s憩室的诊断价值[J]. 医学影像学杂志, 2014, 24(1):76-79.
[5]
Bohm M, Siwiec RM, Wo JM. Diagnosis and management of small intestinal bacterial overgrowth [J]. Nutr Clin Pract, 2013, 28(3):289-299.
[6]
Karaman K, Tuğmen C, Taş A, et al. Mesenteric localization of Meckel’s diverticulum[J]. Turk J Gastroenterol, 2013, 24(2):189-190.
[7]
Malik BA, Xie YY, Wine E, et al. Diagnosis and pharmacological management of small intestinal bacterial overgrowth in children with intestinal failure[J]. Can J Gastroenterol, 2011, 25(1):41-45.
[8]
汪东兴. 内镜在诊断消化道憩室中的临床研究[J]. 心血管病防治知识:学术版, 2015, 5(8):153-154.
[9]
杜国忠,朱北川. 大小肠双充盈法肠道CT造影对不明原因消化道出血的诊断价值[J]. 中国临床医学影像杂志, 2016, 27(2):114-117.
[10]
Shen XF, Guan WX, Cao K, et al. Small bowel volvulus with jejunal diverticulum: primary or secondary?[J]. World J Gastroenter, 2015, 21(36):10480-10484.
[11]
Furukawa K, Yoshida K, Nojiri T, et al. Adult intussusception caused by Meckel’s diverticulum complicated by anisakiasis of the small intestine: report of a case[J]. Clin J Gastroenterol, 2014, 7(4):316-319.
[12]
Chen Y, Chiu CT, Hsu CM, et al. Enteroscopic diagnosis and management of small bowel diverticular hemorrhage: a multicenter report from the Taiwan Association for the study of small intestinal diseases[J]. Gastroenterol Res Pract, 2015, 2015:564-566.
[13]
刘伟,余永强,孟翔凌,等.小肠双向双对比造影对成人Meckel憩室的诊断价值[J].腹部影像学,2014,29(1):73-76.
[14]
Won Y, Lee HW, Ku YM, et al. Multidetector-row computed tomography (MDCT) features of small bowel obstruction (SBO) caused by Meckel’s diverticulum[J]. Diagn Interv Imaging, 2016, 97(2):227-232.
[15]
邹军,杨蓉,孙秀静, 等. 空回肠憩室54例临床特点分析及警示[J]. 中国实验诊断学, 2016, 20(8):32-34.
[16]
张志斌,李东印,谷川,等. 空肠多发憩室导致肠梗阻的诊断与治疗[J]. 中华普通外科杂志, 2014, 29(7):524-526.
[17]
Lin S, Suhocki PV, Ludwig KA, et al. Gastrointestinal bleeding in adult patients with Meckel’s diverticulum: the role of technetium 99m pertechnetate scan[J]. South Med J, 2002, 95(11):1338-1341.
[18]
Turk E, Tan A, Karaca F, et al. Postoperative intestinal obstruction caused by meckel’s diverticulitis after appendectomy[J]. Open J Pediatr, 2013, 3(4):346-349.
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