Perforated diverticulitis in the setting of ulcerative colitis: An unusual case report.
Perforated diverticulitis in the setting of ulcerative colitis: An unusual case report.
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DOI：
10.1016/j.ijscr.2018.06.014
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发表时间：
2018
影响因子：
0.6
通讯作者：
Kasten KR
中科院分区：
文献类型：
--
作者：
Baimas-George M;Cetrulo L;Kao A;Kasten KR
憩室炎与UC的关联是罕见的。IBD的后遗症可以模仿憩室并发症。在诊断憩室炎伴基础UC之前，应考虑IBD和SCAD的误诊。憩室炎与溃疡性结肠炎（UC）的相关性很少见，也没有很好的描述。炎症性肠道疾病（IBD）的后遗症，例如穿孔和瘘管形成，可以模拟憩室并发症。因此，在IBD患者中，可能难以区分此类并发症的病因并提供明确的护理。一名43岁男性，有长期UC病史，出现自发性乙状结肠穿孔，随后出现结肠泡和结肠皮肤瘘并发症，需要多次手术干预。最终，病因被证实为穿孔性憩室炎叠加严重溃疡性结肠炎。由于穿孔性憩室炎合并UC在目前的文献中是一种罕见的疾病，并且有许多诊断困难使这种情况复杂化。重要的是要排除其他可能具有重叠特征的实体，例如IBD或憩室相关节段性结肠炎（SCAD）的误诊。虽然憩室炎在UC的设置是一种罕见的表现，它仍然是重要的医生，以考虑这种情况下，当遇到患者谁可能会出现在类似的方式。因此，我们提出了一个过程，以帮助诊断和管理，使最终的护理可能不会被推迟。
The association of diverticulitis with UC is rare. Sequelae of IBD can mimic diverticular complications. Consider misdiagnosis of IBD and SCAD before making the diagnosis of diverticulitis with underlying UC. The association of diverticulitis with ulcerative colitis (UC) is rare and not well described. The sequelae of inflammatory bowel disease (IBD) such as perforation and fistula formation can mimic diverticular complications. Therefore, in an IBD patient, it can be difficult to distinguish the etiology of such complications and render definitive care. A 43-year-old man with a long history of UC presented with spontaneous sigmoid perforation and subsequent complications of colovesicular and colocutaneous fistulae requiring multiple procedural interventions. Ultimately, the etiology was confirmed as perforated diverticulitis superimposed on severe ulcerative colitis. As perforated diverticulitis superimposed on UC is a rare entity in the current literature and there are many diagnostic difficulties that complicate this scenario. It is important to rule out other entities such as misdiagnosis of IBD or segmental colitis associated with diverticula (SCAD) that may have overlapping features. Although diverticulitis in the setting of UC is an uncommon presentation, it remains important for medical practitioners to consider this scenario when encountering patients who may present in a similar fashion. As such, we put forth a process to aid in a diagnosis and management such that definitive care may not be delayed.