Schmidt C, Bewig B, Klomp H-J
Klinik für Allgemeine Chirurgie und Thoraxchirurgie des Universitätsklinikums Schleswig-Holstein, Kiel.
Zentralbl Chir. 2003 Feb;128(2):102-5. doi: 10.1055/s-2003-37762.
Abdominal tuberculosis is a rare disease. Therapy usually consists in drug treatment while surgery is only performed in complicated cases. We report on a 75 year-old man who presented with clinical and radiologic signs of bowel obstruction. The patient complained of weight loss and B-symptoms. There was a history of drug treatment for tuberculosis of the neck and throat in the medical department four weeks prior to admission. Intraoperatively a coecum stenosis was found due to a large tumor that macroscopically appeared with a diffuse carcinomatosis of the peritoneum. A right hemicolectomy was performed. Histopathology findings revealed a granulomatous inflammation with epithelioid cells. Signs of peritoneal carcinomatosis were not seen. The patient recovered well after an additional tuberculostatic treatment and was discharged after 14 days. At present he is free of symptoms. Even after tuberculostatic treatment lymphatic tuberculosis might show signs of progression that can lead to an abdominal presentation.
腹部结核是一种罕见疾病。治疗通常包括药物治疗，仅在复杂病例中进行手术。我们报告一名75岁男性，他出现了肠梗阻的临床和影像学征象。患者主诉体重减轻及B症状。入院前四周在内科有颈部和喉部结核的药物治疗史。术中发现盲肠狭窄是由一个大肿瘤所致，该肿瘤肉眼可见伴有弥漫性腹膜癌病。实施了右半结肠切除术。组织病理学检查结果显示为伴有上皮样细胞的肉芽肿性炎症。未见腹膜癌病迹象。在追加抗结核治疗后患者恢复良好，14天后出院。目前他无症状。即使经过抗结核治疗，淋巴结核仍可能出现进展迹象，进而导致腹部表现。
