小肠憩室病的临床及病理特点(附33例报告)

The clinic and pathology of small intestine diverticular disease(a report of 33 cases).

目的 总结小肠憩室病的临床、病理特点和诊治体会。方法 对 33例小肠憩室病例的临床和病理进行回顾性分析。结果 (1)术前 5例十二指肠憩室中 4例确诊 ,2 8例空回肠憩室仅 1例确诊。 (2 )小肠憩室的临床并发症有小肠梗阻 9例 ,憩室出血 6例 ,余有憩室穿孔 ,憩室结石等。 (3)术后 32例痊愈 ,1例死于多器官功能障碍综合征 (MODS)。 (4)组织病理学特点 :有并发症的憩室都有炎症表现 ,3例有溃疡。在切除有并发症的Meckel憩室 (MD)标本中 ,4 3%含有异位组织。结论 小肠憩室可成为腹部严重并发症的病因。MD并发症与憩室粘膜异位组织的类型有关。MD最常见的并发症为肠梗阻 ,且最多为肠套叠引起。

Objective To summarize the clinical and pathological characteristics of the small intestine diverticular disease and the experience of diagnosis and management. Methods Thirty three cases with small intestine diverticulum were retrospectively analyzed.Results (1) The diagnosis was made preoperatively in 4 duodenal diverticula and only 1 jejunal diverticulum.(2)Clinical complications included obstruction in 9 cases, bleeding in 6 cases, perforation in 4 cases,enterolith in 2 cases, neoplasm in 1 case.(3) Thirty two cases recovered uneventfully after operation,1 case died of multi organ dysfunction syndrome (MODS).(4) All the diverticula with complications had histopathological signs of inflammation and 3 cases had signs of ulcer.In the Meckel diverticulum (MD) with complications,ectopic mucosa presented in 43% of the resected specimens.Conclusion Diverticulum can be the cause of serious abdominal complications. The histologic type of the ectopic mucosa has correlation with the complications of MD. Obstruction is the most common complication,and intussusception is one of the most common causes of obstruction.