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文献考察１）：右側憩室炎よりＳ状結腸憩室炎の方が重症度が高い．
Eur Radiol. 2002 May;12(5):1145-9.
Colonic diverticulitis: impact of imaging on surgical management -- a prospective study of 542 patients.
Ambrosetti P, Becker C, Terrier F.
The aim of this study was to compare the performance of the CT and the water-soluble contrast enema (CE) in the diagnosis and the severity of acute left-colonic diverticulitis, and to recognize the impact of CT during the acute phase and after a first acute episode successfully treated medically. From 1986 to 1997, all patients admitted in our emergency center with clinically suspected left-colonic diverticulitis had a CE and a CT within 72 h of their admission, unless clinical findings required immediate laparotomy. They were prospectively included in the study if one or both radiological exams showed signs of acute diverticulitis and/or diverticulitis was surgically removed and histologically proven. Diverticulitis was considered moderate when CT showed localized thickening of the colonic wall (5 mm or more) and inflammation of pericolic fat and CE showed segmental lumen narrowing and tethered mucosa; it was considered severe when abscess and/or extraluminal air and/or contrast were observed on CT and when one or both of the latter signs were seen on CE. Five hundred forty-two patients entered the study; 465 patients (86%) had a CT exam, 439 (81%) had a CE, and 420 (77%) had both exams. The performance of CT is significantly superior to CE in terms of sensitivity (98 vs 92%, p
文献考察２）：術前に憩室炎と診断できたのは44％，36.8%は急性虫垂炎と診断された．
【消化管憩室と腹部救急疾患】 大腸憩室炎の手術的治療
Author：伊藤博(富山市立富山市民病院), 泉良平, 廣澤久史, 角谷直孝, 福島亘, 村岡恵一, 寺田逸郎, 天谷公司, 山崎徹
Source：日本腹部救急医学会雑誌(1340-2242)20巻5号 Page675-681(2000.07)
Abstract：対象57例の内訳は男41例,女16例で平均年齢は41.8歳であり,発生部位は右側結腸が54例,左側結腸3例であり,S状結腸及び直腸憩室では穿孔による腹膜炎を2例に認めた.初発症状では右下腹部痛が49例と最も多く認められた.術前に憩室炎と診断できたのは25例で21例は急性虫垂炎と診断され手術が施行された.術式は回盲部切除術が35例,虫垂切除術を併施した憩室切除術10例,結腸部分切除術6例,右(半)結腸切除術4例,ハルトマン手術が2例であった.術後入院期間は平均21.8±12.5日で,術後合併症を17例に認めた.合併症の内訳は縫合糸膿瘍が8例,亜腸閉塞4例,遺残膿瘍2例,心不全1例で,腹膜炎の2例は多臓器不全を併発し,うち1例は死亡した.その他は全例保存的治療にて軽快し退院した.右側憩室炎は急性虫垂炎との鑑別が困難な例が多く,また左側憩室炎では穿孔によって重篤な腹膜炎になり,大腸憩室炎に対しては早期診断と治療が重要である．
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