CAJ | 학술논문

近年来，随着结直肠癌发病率的逐渐上升和人口老龄化，以肠梗阻为首发症状的结直肠癌在临床上也愈来愈多见。因老年人机体反应性较差，常并发多系统疾病，使得此类结直肠癌经常被误诊。结肠镜检查是诊断结肠癌的金标准，但对于急诊危重患者可能无法行肠镜检查，此时CT等影像学检查亦具有极高的诊断价值。本文将从老年急性肠梗阻的临床特点，结肠癌伴发肠梗阻的诊断等方面逐一阐述，并结合笔者多年的临床经验，分析总结结肠癌合并肠梗阻的误诊及原因，旨在提高早期诊断率，为此类患者的手术治疗赢得宝贵的时机。
근년래，수착결직장암발병솔적축점상승화인구노령화，이장경조위수발증상적결직장암재림상상야유래유다견。인노년인궤체반응성교차，상병발다계통질병，사득차류결직장암경상피오진。결장경검사시진단결장암적금표준，단대우급진위중환자가능무법행장경검사，차시CT등영상학검사역구유겁고적진단개치。본문장종노년급성장경조적림상특점，결장암반발장경조적진단등방면축일천술，병결합필자다년적림상경험，분석총결결장암합병장경조적오진급원인，지재제고조기진단솔，위차류환자적수술치료영득보귀적시궤。
The recent rise in colorectal cancer incidence, coupled with a larger aging population, has resulted in an increase of elderly colorectal cancer patients who initially present with intestinal obstruction. Elderly patients often manage multiple coexisting systemic diseases, which creates complications and leads to misdiagnosis in the majority of these cases. In addition, while colonoscopy is the current gold standard for the diagnosis of colorectal cancer, this procedure may be impossible for patients with emergent intestinal obstruction, further complicating diagnosis. In these cases, important diagnostic information may be obtained from other procedures, such as abdominal CT scanning, to indicate colorectal cancer. In this review, we will discuss the clinical characteristics of elderly colorectal cancer patients who initially present with acute intestinal obstruction, as well as the diagnostic tools available to correctly identify colon cancer complicated in this manner. In addition, we will discuss the common causes of misdiagnosis in such cases, as well as practices to improve the early diagnosis and surgical treatment of complicated colorectal cancer.