憩室病

最后审阅: 26 四月 2022
最后更新: 01 九月 2021

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
更多 关键诊断因素

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
其他诊断因素

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)
更多 危险因素

诊断性检查

首要检查

  • FBC 和分类计数
  • C 反应蛋白 (CRP)
更多 首要检查

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
更多 需考虑的检查

治疗流程

急症处理

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)

持续性治疗

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

    • 治疗左侧结肠憩室炎的临床实践指南
    • WSES 紧急情况下急性结肠憩室炎的管理指南 2020 年更新版
    更多 指南
  • 患者教育信息

    阑尾炎

    成人便秘

    更多 患者教育信息
  • padlock-locked登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容

内容使用需遵循免责声明