Kim Joo Hyoung, Jeon Yong Cheol, Kim Tae Yeob, Eun Chang Soo, Sohn Joo Hyun, Han Dong Soo, Jang Jae Jung, Park Yong Wook
Department of Internal Medicine, Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
Korean J Gastroenterol. 2008 Nov;52(5):320-4.
Intestinal tuberculosis is a common disease of extrapulmonary tuberculosis and should be differentiated from the inflammatory bowel diseases and malignancy such as Crohn's disease, ulcerative colitis, amebic colitis, and colon cancer. Most frequently involved sites (75% of cases) are the terminal ileum and cecum. Other sites of involvement, in order of frequency, are ascending colon, jejunum, appendix, duodenum, stomach, esophagus, sigmoid colon, and rectum. Intestinal tuberculosis simultaneously involving the stomach and colon has been very rarely reported. Recently, we experienced a case of synchronous gastric and colonic ulcers with granulomatous inflammation. Although we did not find acid fast bacilli and the culture test was negative, empirical anti-tuberculosis therapy resulted in dramatic clinical and endoscopic improvement. We report a rare case of multifocal gastrointestinal tuberculosis with a review of literature.
肠结核是肺外结核的常见疾病,应与炎症性肠病和恶性肿瘤如克罗恩病、溃疡性结肠炎、阿米巴结肠炎及结肠癌相鉴别。最常受累部位(75%的病例)是回肠末端和盲肠。其他受累部位按频率依次为升结肠、空肠、阑尾、十二指肠、胃、食管、乙状结肠和直肠。同时累及胃和结肠的肠结核报道极少。最近,我们遇到一例伴有肉芽肿性炎症的同步胃和结肠溃疡病例。尽管我们未发现抗酸杆菌且培养试验为阴性,但经验性抗结核治疗使临床和内镜表现显著改善。我们报告一例罕见的多灶性胃肠道结核病例并复习相关文献。