Rasheed S, Zinicola R, Watson D, Bajwa A, McDonald P J
St Mark's Hospital, Harrow, Middlesex, UK.
Colorectal Dis. 2007 Nov;9(9):773-83. doi: 10.1111/j.1463-1318.2007.01337.x. Epub 2007 Sep 14.
Reports suggest that the rates of tuberculosis (TB) continue to rise in the UK and throughout the world. The spread of the disease is aided by poverty, overcrowding, co-infection with human immunodeficiency virus and drug resistance. Consistent with the overall trend, intra-abdominal and gastrointestinal (GI) TB rates are rising. Tuberculosis is a treatable disease, whether occurring in the lungs or at extra-pulmonary sites but the nonspecific features of the disease result in difficulty in establishing a diagnosis. In this report, we have concentrated on the benefits and potential pitfalls of diagnostic methods.
A literature review was performed using the National Library of Medicine's Pubmed Database using the keywords diagnosis, management, abdominal and GI TB.
Abdominal TB presents a particular challenge, as the diverse features of the disease do not readily suggest a particular diagnosis and diagnostic delays lead to significant morbidity and mortality. A number of investigative methods have been used to aid in the diagnosis of abdominal and GI TB.
The nonspecific presentation of abdominal and GI TB present challenges in the diagnosis of this increasingly common disease. A high index of suspicion is an important factor in early diagnosis. After a diagnosis has been established, prompt initiation of treatment helps prevent morbidity and mortality.
报告显示,英国及全球范围内结核病(TB)发病率持续上升。贫困、过度拥挤、合并人类免疫缺陷病毒感染及耐药性助长了该疾病的传播。与总体趋势一致,腹腔及胃肠道(GI)结核病发病率也在上升。结核病是一种可治疗的疾病,无论发生在肺部还是肺外部位,但该疾病的非特异性特征导致诊断困难。在本报告中,我们着重探讨了诊断方法的益处及潜在陷阱。
使用美国国立医学图书馆的PubMed数据库,以诊断、管理、腹腔及胃肠道结核病为关键词进行文献综述。
腹腔结核带来了特殊挑战,因为该疾病的多样特征不易提示特定诊断,诊断延迟会导致显著的发病率和死亡率。已采用多种检查方法辅助诊断腹腔及胃肠道结核病。
腹腔及胃肠道结核病的非特异性表现给这种日益常见疾病的诊断带来了挑战。高度的怀疑指数是早期诊断的重要因素。确诊后,及时开始治疗有助于预防发病率和死亡率。