Department of Gastroenterology, Juntendo University, School of Medicine, Tokyo, Japan.
Med Sci Monit. 2009 Oct;15(10):CS151-154.
Although minor bleeding is fairly common among cases of gastrointestinal tuberculosis, massive hemorrhage necessitating blood transfusion is rare.
A 72-year-old woman presented to the hospital with hematochezia. Colonoscopy revealed multiple ulcers, including round ulcers, throughout the large intestine. Upper gastrointestinal endoscopy revealed multiple duodenal ulcers. Hemostasis was performed on the bleeding point, but other untreated ulcers exhibited recurrent bleeding. Fecal culture results established the diagnosis of gastrointestinal tuberculosis. The patient was put on a standard antituberculosis regimen and remains in remission.
Gastrointestinal tuberculosis should be considered as one of the causes for massive and intractable gastrointestinal bleeding.
尽管胃肠道结核病例中常见轻微出血,但需要输血的大出血则较为罕见。
一名 72 岁女性因血便就诊于医院。结肠镜检查显示大肠内有多个溃疡,包括圆形溃疡。上消化道内镜检查显示多个十二指肠溃疡。对出血点进行了止血,但其他未治疗的溃疡仍反复出血。粪便培养结果确立了胃肠道结核的诊断。患者接受了标准的抗结核治疗方案,目前仍处于缓解期。
胃肠道结核应被视为导致大量且难以控制的胃肠道出血的原因之一。