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梗阻性黄疸和呕血:两例腹内结核的不寻常表现病例

Obstructive jaundice and hematemesis: two cases with unusual presentations of intra-abdominal tuberculosis.

作者信息

Jazet Ingrid M., Perk Lars, De Roos Albert, Bolk Jan H., Arend Sandra M.

机构信息

Department of General Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands.

出版信息

Eur J Intern Med. 2004 Jul;15(4):259-261. doi: 10.1016/j.ejim.2004.04.004.

Abstract

Extrapulmonary tuberculosis (TB) is notorious for its many manifestations, which can lead to delayed diagnosis and treatment. In particular, abdominal tuberculosis is easily overlooked because the incidence is low and because it can mimic common noninfectious abdominal syndromes. We describe here a 37-year-old Moroccan man presenting with obstructive jaundice and a 42-year-old man originating from the Philippines who presented with recurrent hematemesis due to portal hypertension. In both patients, a retroperitoneal mass was found and tuberculosis was first diagnosed after a diagnostic laparotomy. Tuberculosis should be included in the differential diagnosis of intra-abdominal mass lesions, especially in persons originating from regions where tuberculosis is endemic. Invasive procedures are often required to obtain adequate diagnostic samples.

摘要

肺外结核病以其多种表现而声名狼藉,这些表现可能导致诊断和治疗延迟。特别是腹部结核很容易被忽视,因为其发病率低,而且可能类似常见的非感染性腹部综合征。我们在此描述一名37岁的摩洛哥男子,他表现为梗阻性黄疸,以及一名来自菲律宾的42岁男子,他因门静脉高压反复出现呕血。在这两名患者中,均发现了腹膜后肿块,在诊断性剖腹手术后首次诊断为结核病。腹部肿块病变的鉴别诊断应包括结核病,尤其是在结核病流行地区的人群中。通常需要进行侵入性操作以获取足够的诊断样本。

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