结核所致肠梗阻
Intestinal obstruction due to tuberculosis.
作者信息
Nguyen Van Hai
机构信息
Department of General Surgery, Nhan Dan Gia Dinh Hospital, University of Medicine and Pharmacy, 215 An Duong Vuong Str, Dist 5, Ho Chi Minh City, Vietnam.
出版信息
Asian J Surg. 2002 Apr;25(2):145-8. doi: 10.1016/S1015-9584(09)60163-9.
OBJECTIVES
Intestinal obstruction due to tuberculosis is a rare form of mechanical bowel obstruction. The objectives of this study were to determine the clinical features, to evaluate the role of surgery and to choose procedures in management of this disease.
METHODS
In this 7-year retrospective study (from 1992 to 1998), 23 patients (20 males, three females) were included, accounting for 4.5% of all mechanical intestinal obstructions. More than 80% of the patients had a clinical picture of lower small bowel obstruction, while 90.5% of patients had advanced pulmonary tuberculosis.
RESULTS
In 54.6% of cases, obstruction occurred in the ileocaecal region. The main lesion causing obstruction was intestinal tuberculosis in the hypertrophic form (86.4%). Diagnosis of intestinal tuberculosis as a cause of obstruction was not easy because it has no specific symptoms and signs.
CONCLUSION
In terms of management, ileocolostomy was often used (68.2%) but long-term results were not very good. Blind loop syndrome was one of its disadvantages. Resection may be the safe and effective procedure.
目的
结核性肠梗阻是机械性肠梗阻的一种罕见形式。本研究的目的是确定其临床特征，评估手术的作用并选择该病治疗的手术方式。
方法
在这项为期7年的回顾性研究（1992年至1998年）中，纳入了23例患者（20例男性，3例女性），占所有机械性肠梗阻患者的4.5%。超过80%的患者有低位小肠梗阻的临床表现，而90.5%的患者有晚期肺结核。
结果
54.6%的病例梗阻发生在回盲部。导致梗阻的主要病变是肥厚型肠结核（86.4%）。将肠结核诊断为梗阻原因并不容易，因为它没有特异性的症状和体征。
结论
在治疗方面，常采用回结肠造口术（68.2%），但长期效果不太理想。盲袢综合征是其缺点之一。切除可能是安全有效的手术方式。
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