Naga M I, Okasha H H, Ismail Z, El-Fatatry M, Hassan S, Monir B E
Kasr El-Aini Hospitals and Cairo University, Cairo, Egypt.
Gastrointest Endosc. 2001 Jun;53(7):789-93. doi: 10.1067/mge.2001.114965.
GI tuberculosis is a diagnostic challenge, particularly in the absence of evidence of pulmonary infection. It may mimic many other abdominal diseases such as other infectious processes, tumors, and Crohn's disease. In the absence of positive laboratory and radiologic tests, the diagnosis is often established definitively by obtaining a surgical specimen. Colonoscopy, however, has been used successfully to diagnose the disease and thus avoid the morbidity and mortality associated with exploratory laparotomy.
An evaluation was conducted of colonoscopic features in 10 patients with colonic tuberculosis.
In all cases there was ileocecal involvement; total colonic involvement was found in only 1 case. The colonoscopic appearance included the following: ulcerated lesions, sessile firm polyps, masses, and small diverticula, ranging from 3 to 5 mm in diameter. In 5 of our patients the diagnosis was confirmed bacteriologically, in 3 with endoscopic biopsy material, and in 2 by sputum examination. In all cases antituberculous therapy produced remarkable symptom and endoscopic improvement.
This report highlights the importance of colonoscopy in the diagnosis of tuberculous involvement of the GI tract.
胃肠道结核是一项诊断难题，尤其是在没有肺部感染证据的情况下。它可能会模仿许多其他腹部疾病，如其他感染性疾病、肿瘤和克罗恩病。在实验室检查和影像学检查结果均为阴性时，通常通过获取手术标本才能明确诊断。然而，结肠镜检查已成功用于诊断该病，从而避免了与剖腹探查术相关的发病率和死亡率。
对10例结肠结核患者的结肠镜特征进行了评估。
所有病例均累及回盲部；仅1例累及全结肠。结肠镜表现包括以下几种：溃疡性病变、无蒂实性息肉、肿块和直径为3至5毫米的小憩室。我们的患者中有5例经细菌学确诊，3例通过内镜活检材料确诊，2例通过痰液检查确诊。在所有病例中，抗结核治疗均使症状和内镜检查结果有显著改善。
本报告强调了结肠镜检查在诊断胃肠道结核累及情况中的重要性。
