結腸憩室出血之診斷及處置

10.6666/ClinMed.2017.79.2.017

林裕祥

結腸憩室(colonic diverticulum) ； 憩室炎(diverticulosis) ； 結腸憩室出血(Colonic diverticular bleeding)

臨床醫學月刊

79卷2期（2017 / 02 / 24）

90 - 92

繁體中文

結腸憩室(colonic diverticulum) 出血是成人下消化道出血的最常見原因之一。大多數的憩室出血為自發性，並無特殊原因，約七成五的病患可以自行止血。較常見發生結腸憩室出血的位置以右側較多，約五到九成。大多數的出血量非常細微，需要以糞便潛血檢查才能偵測得到。但是，也有部分結腸憩室出血會以大量便血來表現，大約占總體憩室出血的三到五成。一般病患以無痛便血作為臨床表現，但是部分病患還是會有腹脹、絞痛、腹瀉等情形。診斷結腸憩室出血可以靠大腸鏡或血管攝影。大腸鏡可以用來確認出血點及進行治療。如果大腸鏡無法成功止血，可以考慮核醫攝影( 標誌紅血球攝影) 合併血管攝影來確認出血點。當出血持續不止或反覆出血時，就需要考慮以手術切除來進行治療。

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