[克罗恩病与腹部结核：与诊断错误相关的并发症]
[Crohn disease and abdominal tuberculosis: complications related to a diagnostic error].
作者信息
Demory Didier, Forel Jean-Marie, Michel Fabrice, Guillin-Poujol Alexandra, Consentino Bernard, Gainnier Marc, Papazian Laurent, Sainty Jean-Marie
机构信息
Service de réanimation médicale, Hôpital Sainte-Marguerite, Marseille.
出版信息
Presse Med. 2006 Jan;35(1 Pt 1):51-4. doi: 10.1016/s0755-4982(06)74519-5.
INTRODUCTION
We report the case of a patient with abdominal tuberculosis initially treated as Crohn disease.
CASE
A 50-year-old man, diagnosed with Crohn disease, was admitted to the intensive care unit for acute respiratory failure. After a new diagnosis of pulmonary and ileocecal tuberculosis and appropriate treatment for it, he improved.
DISCUSSION
It is difficult - but essential - to differentiate intestinal tuberculosis and Crohn disease, for the immune suppression necessary to treat the latter can induce severe complications of the former. Management of intestinal tuberculosis is primarily medical, with surgery reserved for complications such as obstruction, fistulization, perforation, and bleeding.
引言
我们报告一例最初被诊断为克罗恩病的腹部结核患者。
病例
一名50岁男性，被诊断为克罗恩病，因急性呼吸衰竭入住重症监护病房。在重新诊断为肺和回盲部结核并进行相应治疗后，他的病情有所改善。
讨论
区分肠结核和克罗恩病既困难又至关重要，因为治疗后者所需的免疫抑制可能会诱发前者的严重并发症。肠结核的治疗主要是药物治疗，手术仅用于治疗诸如梗阻、瘘管形成、穿孔和出血等并发症。
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