小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 左下腹痛
- 白细胞增多
- 发热
- 直肠出血
其他诊断因素
- 局限于左下腹
- 左下腹痛
- 腹胀
- 便秘
- 直肠指诊时盆腔压痛
- 弥漫性腹部压痛
- 腹泻
- 可触及腹部包块
危险因素
- 低膳食纤维
- 高盐、肉类多、高糖的饮食结构
- 50 岁以上
- 肥胖（BMI＞30）
- 使用非甾体类抗炎药（NSAID）
诊断性检查
首要检查
- FBC 和分类计数
- C 反应蛋白 (CRP)
需考虑的检查
- 腹部 CT 扫描
- 血液培养
- 腹部 X 光
- 肠道超声（分级加压）
- 腹部 MRI 扫描
- 胸部 X 线检查
- 对比灌肠
- 结肠镜检查
- 乙状结肠镜检查
- 血管造影术
- 同位素标记红细胞核素扫描
- 腹腔镜检查/开腹探查术
治疗流程
无症状性憩室炎
有症状性憩室病
症状性憩室炎（非复杂性）
症状性憩室炎（复杂性）
复发性憩室炎
撰稿人
作者
Mohamed A. Thaha, PhD, FRCS (Gen Surg), PG Cert Hlt Econ
Senior Lecturer & Consultant in Colorectal Surgery
National Bowel Research Centre
Blizard Institute
Barts and The London School of Medicine and Dentistry
Queen Mary University of London
The Royal London Hospital
Barts Health NHS Trust
London
UK
利益声明
MAT declares that he has no competing interests.
Jayan Dewanta Jayasinghe, MD
International Senior Fellow in Colorectal Surgery
The Royal London Hospital
Barts Health NHS Trust
London
UK
利益声明
JDJ declares that he has no competing interests.
鸣谢
Dr Mohamed A. Thaha and Dr Jayan D. Jayasinghe would like to gratefully acknowledge Dr Emma Carrington, Ms Kathryn Lynes, Professor Norman S. Williams, and Dr Abbasi Akhtar, the previous contributors to this topic.
利益声明
EC has received honoraria for teaching, and acts as a consultant for Laborie Medical Management Systems. KL has received funding for a research fellowship from the David Johnston Fellowship through the Royal College of Surgeons of England. NSW is an author of a reference cited in this topic. AA declares that he has no competing interests.
同行评议者
Ned Snyder, MD, FACP
Professor of Medicine
Chief of Clinical Gastroenterology and Hepatology
University of Texas Medical Branch
Galveston
TX
利益声明
NS declares that he has no competing interests.
Nicolas Regenet, MD
Clinic of digestive and endocrine surgery
University Hospital
Nantes
France
利益声明
NR declares that he has no competing interests.
鉴别诊断
- 子宫内膜异位症
- 结直肠癌
- 阑尾炎
更多 鉴别诊断指南
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- 急性左侧结肠憩室炎发作后，用于诊断性评估的结肠镜检查以及预防复发的干预措施
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