Surgical Management of Cecal Diverticulitis

　　　　　盲腸憩室是一種不常見的疾病，通常只有在發炎、穿孔或出血時才顯示出症狀。 長庚醫院於 1985 年至 1991 年一共有十四例盲腸憩室炎。其中男性九位，女性五位，平均 年齡 43.3 歲。主訴仍以腹痛為主（ 93.0% ），尤其是右下腹痛或轉移性右下腹痛（ 71% ），理學檢查和實驗室檢查和急性闌尾炎不易區分。 術前正確診斷率只有二例（ 14% ）， 大多數病例是在手術當中得到診斷（ 64% ），腹部電腦斷層檢查能提高術前診斷率。 對於無併發症的盲腸憩室炎，手術切除闌尾加上引流，並配合抗生素常可治癒。對已有併發 症的盲腸憩室炎（如穿孔、腹膜炎、?硎煄B腫瘤或膿瘍形成），則必須切除部份大腸才能治 癒此病。
　　　　　Divericular disease of the cecum is a common condition in Taiwan and all of Asia. It is generally an asymptomatic lesion that only manifests itself following inflammatory, perforative or hemorrhagic events. This study is based on 14 cases of cecal diverticulitis proven by surgery at Chang Gung Memorial Hospital (CGMH). The 14 patients, 9 men and 5 women, ranged in age from 20 to 68 years. Their major complaint was abdominal pain (92.9%). It was not easy to diferentiate the disease from acute appendicitis preoperatively. The preoperative diagnosis was accurate in only two cases (14%), and in nine (64%) the diagnosis was made during surgery. Abdominal computed tomography can offer information about cecal diverticulitis. The operative procedures undertaken were a drainage procedure with an appendectomy in six cases and a colectomy n eight cases. The morbidity rate was 14.3% (2/14). There were no mortalities. The average hospital stay was 10.2 days. Five patients, who received the drainage procedure with appendectomies, were free of major symptoms for the four to nine years of follow-up. One patient was lost to follow-up. Simple drainage with an appendectomy is an adequate procedure for uncomplicated cecal diverticulitis. A colectomy is a reliable procedure for complicated cecal diverticulitis, i.e., complicated with perforation, peritonitis, obstruction, fistula, tumor or abscess formation.