大肠梗阻是结直肠癌的常见症状,发病率范围为 15%-29%。[2]Tekkis PP, Kinsman R, Thompson MR, et al. The Association of Coloproctology of Great Britain and Ireland study of large bowel obstruction caused by colorectal cancer. Ann Surg. 2004;240:76-81.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1356377/http://www.ncbi.nlm.nih.gov/pubmed/15213621?tool=bestpractice.com另外,梗阻也是结直肠癌急诊手术的最常见指征,在急症中占比 77%。 [3]Phillips RK, Hittinger R, Fry JS, et al. Malignant large bowel obstruction. Br J Surg. 1985;72:296-302.http://www.ncbi.nlm.nih.gov/pubmed/3986481?tool=bestpractice.com 类似地,结肠恶性肿瘤也是成人大肠梗阻的最常见原因。[4]Baer C, Menon R, Bastawrous S, et al. Emergency Presentations of Colorectal Cancer. Surg Clin North Am. 2017 Jun;97(3):529-545.http://www.ncbi.nlm.nih.gov/pubmed/28501245?tool=bestpractice.com
对于结肠扭转,来自美国的数据显示年发病率为 1.47/100,000,而在英国为每年 1.7/100,000。[5]Ballantyne GH. Review of sigmoid volvulus: clinical pattern and pathogenesis. Dis Colon Rectum. 1982;25:823-830.http://www.ncbi.nlm.nih.gov/pubmed/6293790?tool=bestpractice.com[6]Ballantyne GH. Brandner MD, Beart RW, et al. Volvulus of the colon. Ann Surg. 1985;202:83-92.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1250842/pdf/annsurg00101-0091.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/4015215?tool=bestpractice.com 来自非洲的相关报告显示高得多的发病率(即每年 12/100,000)。[1]Shagen van Leewen JH. Sigmoid volvulus in a West African population. Dis Colon Rectum. 1985;28:712-716.http://www.ncbi.nlm.nih.gov/pubmed/4053876?tool=bestpractice.com[6]Ballantyne GH. Brandner MD, Beart RW, et al. Volvulus of the colon. Ann Surg. 1985;202:83-92.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1250842/pdf/annsurg00101-0091.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/4015215?tool=bestpractice.com[7]Anderson JR, Lee D. The management of acute sigmoid volvulus. Br J Surg. 1981;68:117-120.http://www.ncbi.nlm.nih.gov/pubmed/7459614?tool=bestpractice.com[8]Raveenthiran V, Madiba TE, Atamanalp SS, et al. Volvulus of the sigmoid colon. Colorectal Dis. 2010;12:e1-e17.http://www.ncbi.nlm.nih.gov/pubmed/20236153?tool=bestpractice.com