맹장부 및 상행 결장의 게실 질환에 대한 임상적 고찰
Clinical Analysis of Diverticulosis of the Cecum and Ascending Colon
김규열, 남창우, 고병균, 조홍래, 박찬진, 최대화,
소속 상세정보
김규열 ( Kim Kyu-Yeol )
울산대학교 의과대학 울산대학교병원 외과
남창우 ( Nam Chang-Woo )
울산대학교 의과대학 울산대학교병원 외과학교실
고병균 ( Ko Byung-Kyun )
울산대학교 의과대학 울산대학교병원 외과
조홍래 ( Cho Hong-Rae )
울산대학교 의과대학 울산대학교병원 외과학교실
박찬진 ( Park Chan-Jin )
울산대학교 의과대학 울산대학교병원 외과
최대화 ( Choi Dae-Hwa )
울산대학교 의과대학 울산대학교병원 외과
KMID : 0356719980140030595
Abstract
Background: Diverticulosis of the cecum and ascending colon is a rare disease in Western countries, it is more common in the Orient. Making the diagnosis preoperatively could be difficult, and the intraoperative assessment and decision of optimal treatments are difficult.
Methods: Therefore, we reviewed the patient’s charts of diverticulosis of the cecum and ascending colon at our hospital from 1992 to 1997.
Results: During the past 5 years, a total of 53 cases of diverticulosis of the cecum and ascending colon had been treated at this hospital. Mean age was 41.8 years (range 20-70). The male to female ratio was 1.8 : 1. Frequent complaints were abdominal pain (46 cases, 86.8%), followed by diarrhea (5 cases, 9.3%), indigestion (4 cases, 7.5%), and bowel habits change (2 cases, 3.8%). Mean duration of illness was 3.5 days(range 24 hours∼15 days). In non-surgical cases, diagnoses were established with barium enema, CT scan, or ultrasonography. The accuracy of these methods was 91%, 75%, and 25%. In surgical cases, the preoperative diagnoses were appendicitis(13 cases, 50.1%), diverticulitis (7 cases, 31.8%), and abscess (2 cases, 9.1%). Treatments of the cecum and ascending colon diverticulitis were conservative management (3 teases,58.5%) and surgical treatment (22 cases,41.5%). The operative procedures were right hemicolectomies (2 cases), ileocecal resections (2 cases), diverticulectomies (6 cases) and appendectomies only (11 cases).
Conclusion: These results suggest that correct diagnosis of the diverticulitis of the cecum and ascending colon made before treatment is very important because correct assessment of diverticulitis intraoperatively is difacut. Liberal use of diagnostic modalities could facilitate to make correct diagnosis to set a proper plan for treatment.
키워드
Diverticulosis;Cecum;Ascending colon;Diverticulitis
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