Miura Tomofumi, Shimizu Takao, Nakamura Junichiro, Yamada Satoshi, Yanagi Masahiko, Usuda Hiroyuki, Emura Iwao, Takahashi Toru
Division of Gastroenterology and Hepatology, Nagaoka Red Cross Hospital, Japan.
Nihon Shokakibyo Gakkai Zasshi. 2010 Mar;107(3):416-26.
A 25-year-old woman was admitted with fever and right lower abdominal pain that had started 3 days after the administration of antituberculosis agents for pulmonary tuberculosis. She was given a diagnosis of intestinal tuberculosis with ileo-ileal fistula formation on computed tomography, colonoscopy and laboratory test findings. She was kept on anti-tuberculosis agents. Soon after, ileus and a micro abscess appeared near the fistula. Ileocecal resection with partial ileal resection resulted in a good postoperative clinical course. Tuberculosis is still a major infectious disease. Intestinal tuberculosis is very rarely associated with fistula formation, and when it occurs, is difficult to differentiate from Crohn disease. Our case strongly suggests that typical intestinal tuberculosis findings can help in differential diagnosis between intestinal tuberculosis and Crohn disease.
一名25岁女性因发热及右下腹痛入院,这些症状在开始抗结核治疗肺结核3天后出现。通过计算机断层扫描、结肠镜检查及实验室检查结果,她被诊断为肠结核伴回肠-回肠瘘形成。她继续接受抗结核药物治疗。不久后,瘘管附近出现肠梗阻和微脓肿。行回盲部切除及部分回肠切除术后,临床病程良好。结核病仍然是一种主要的传染病。肠结核很少伴有瘘管形成,一旦发生,很难与克罗恩病相鉴别。我们的病例强烈提示,典型的肠结核表现有助于肠结核与克罗恩病的鉴别诊断。