回盲部憩室炎的诊治探讨

Diagnosis and surgical management of ileoceca diverticulitis

目的探讨回盲部憩室炎的诊断和手术方式的选择。方法12例回盲部憩室炎患者,其中Meckel憩室炎7例,盲肠憩室炎4例,升结肠憩室炎1例。根据憩室部位、大小及周围肠管是否受累选择手术方式,包括憩室单纯切除术、回肠部分切除+端端吻合术、回盲部切除+回肠升结肠端侧吻合术+回肠造瘘术等。结果全组患者均获治愈,无手术并发症发生。结论回盲部憩室炎与急性阑尾炎临床表现极为相似,常需术中探查方能确诊。应根据憩室的具体情况选择合适的术式。

Objective To investigate the diagnosis and surgical procedure selection of ileoceca diverticulitis.Methods Twelve patients with ileoceca diverticulitis,including 7 cases of Meckel's diverticulitis,4 caecal diverticulitis and 1 ascending colon diverticulitis,received surgical approaches,including diverticulectomy,partial ileal resection with end-to-end anastomosis as well as ileocecal resection with end-to-side anastomosis between ileal and ascending colon and ileal fistulation depending on the location and size of the diverticulitis and whether the surrounding intestines were involved.Results All cases were operated successfully without any complications.Conclusion The diagnosis of ileoceca diverticulitis is usually intraoperative due to the similar clinical manifestations between the ileoceca diverticulitis and acute appendicitis.Furthermore,the suitable surgical procedures should be selected on the conditions of diverticulitis.