Inflammatory manifestations at colonoscopy in patients with colonic diverticular disease
Inflammatory manifestations at colonoscopy in patients with colonic diverticular disease
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DOI：
10.1111/j.1365-2036.2010.04530.x
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发表时间：
2011-02-01
影响因子：
7.6
通讯作者：
Brandimarte, G.
中科院分区：
文献类型：
--
作者：
Tursi, A.;Elisei, W.;Brandimarte, G.
P>背景溃疡性结肠炎伴憩室病（UCD）、憩室病相关节段性结肠炎（SCAD）和急性单纯性憩室炎（AUD）可能影响相同的结肠区域，但这些实体在临床实践中的真实发病率尚不清楚。目的评估UCD、SCAD和AUD的发病率和内镜检查结果。方法从2004年1月至2009年6月，连续8525例进行了结肠镜检查。这些疾病的诊断基于特定的内镜和组织学（UCD 和 SCAD）以及内镜和放射学（AUD）模式。结果 25 例患者（0.3%）诊断出溃疡性结肠炎伴憩室病，129 例患者（2%）诊断出 SCAD，130 例患者（2%）诊断出 AUD。在UCD中，在所有病例中，憩室所在结肠区域的炎症总是影响整个结肠粘膜，也涉及憩室口。 SCAD的内镜特征是炎症主要发生在憩室间粘膜内，不累及憩室口。在AUD中，炎症主要影响憩室口和憩室周围粘膜。结论在临床实践中，结肠憩室病出现粘膜炎症的发生率较低，内镜检查是鉴别诊断的主要手段。
P>BackgroundUlcerative colitis with diverticulosis (UCD), segmental colitis associated with diverticulosis (SCAD) and acute uncomplicated diverticulitis (AUD) may affect the same colonic regions, but the real incidence of these entities in clinical practice is unknown.AimTo assess the incidence and the endoscopic findings of UCD, SCAD and AUD.MethodsFrom January 2004 to June 2009, 8525 consecutive colonoscopies were performed. Diagnosis of the diseases was based on specific endoscopic and histological (UCD and SCAD), and on endoscopic and radiological (AUD) patterns.ResultsUlcerative colitis with diverticulosis was diagnosed in 25 patients (0.3%), SCAD was diagnosed in 129 patients (2%) and AUD was diagnosed in 130 patients (2%). In UCD, the inflammation in colonic area harbouring diverticula always affects the overall colonic mucosa in all cases, involving also diverticular orifices. The endoscopic characteristic of SCAD is that inflammation is mainly detected within the inter-diverticular mucosa without involvement of the diverticular orifices. In AUD, the inflammation affects primarily diverticular orifice and peri-diverticular mucosa.ConclusionsIn clinical practice, the incidence of mucosal inflammation in the presence of colonic diverticular disease is low and endoscopy is the mainstay of differential diagnosis.