憩室(症)の臨床的・X線学的研究

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  • 3. Clinical and Roentgenological Studies of Diverticulum and Diverticulosis of the Large Intestine

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The authors had 89 cases with diverticulum and diverticulosis of the large intestine from March, 1970 through March, 1972. The incidence is 8.8% of examined 1013 cases. The 89 cases involved 30 cases (33.7%) with single diverticulum, 40 cases (44.9%) with scat-tered diverticulosis and 19 cases (9-1.4%) with massed diverticulosis.<BR>Localization: About 70% of cases with single diverticulum localized at the right colon (colon ascendens 34.8%, coecum 30.4%) and a few at the left colon (colon sigmoideum 4.3%, colon descendens 4.3%). But cases with massed diverticulosis more frequently localized at left colon than cases with single diverticulum (colon sigmoideum 50.0%, colon descendens 27.8%, colon ascendens 77.8%, coecum 55.6%).<BR>Age: Cases with single diverticulum were observed from 19 years old, but cases with massed diverticulosis were observed from 37 years old and 73.7% of massed diverticulosis were observed over 60 years old. We think that single diverticulum will gradually develop to scattered diverticulosis and massed diverticulosis.<BR>Clinical Features: Diverticulum and diverticulosis are said to cause no symptoms usually. In author's cases, however, abdominal pain was complained in 53.3% of single diverticulum, 44.7% of scattered diverticulosis and 42.1% of massed diverticulosis. Constipa-tion and/or diarrhea was complained in 36.7% of single diverticulum, 10.5% of scattered diverticulosis and 21.1% of massed diverticulosis. In the cases with single diverticulum, the symptoms resembled those of the irritable colon syndrome. Melena and abdominal resistence were observed most frequently in massed diverticulosis (melena 15.8%, abdominal resistence 31.6%). Occult blood reaction by benzidin showed that multiple diverticula (diverticulosis) had tendency to bleed easier than single diverticulum.<BR>X-ray Findings: In cases with massed diverticulosis, many roentgenological changes were observed (marginal irregularity 61.1%, asymmetrical haustra 83.3%, reduced caliber of the lumen 77.8 %, crowded folds 66.7%). No filling defect and extravasation of barium were observed in all cases.

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