대장게실염에 대한 임상적 고찰

Colonic diverticular diseae is one of the most common disease in the geriatric patients in Western countries. Most of diverticular disease in Western countries occur in the left colon, especially around the Sigmoid. In contrast, majority of diverticular disease found in Korea occurs in the right colon, especially in the ceucum. The cecal diverticulitis is very difficult to differentiate from the acute appendicitis due to their similar signs and symptoms. This report is collective analysis of 44 cases of diverticular disease including 21 cases managed surgically at the department of Surgery, Yonsei University College of Medicine from January, 1976 to December, 1985 and 23 cases reported in JKSS between the period of April, 1968 to March, 1985. The results obtained were as follows; 1) There were 36 males and 8 females with the ratio of 4.5:1, significantly higher in males. 2) Mean age was 41.3 years, ranged between 8 to 83 years, and most prevalent in the 5th decade (36.4%) 3) 41 cases (93.2%) were located in thr right colon and 3 (6.8%) were in the left colon. Of these, 33 cases (75%) were found in the cecum. 4) There were 4 cases of associated malignancy with the incidence of 9.1%. 5) The most common preoperative diagnosis of right colonic diverticulitis was acute appendicitis. 6) The operative procedures performed in 39 of 41 right colonic diverticular disease consist of right hemicolectomy in 25 cases, appendectomy and diverticulectomy in 5, diverticulectomy in 3, ileocecal resection in 2, appendectomy and inversion of diverticulum in 2, appenectomy in 1 and exploratory lapartomy and drainage in 1 case. Staged operations were performed for the left colonic diverticular disease with two 2-stage operations and one 3-stage operation.