Tosun Salih, Tosun Alptekin
Department of Abdominal Surgery, Göztepe Research Hospital, Istanbul.
Turk J Gastroenterol. 2010 Mar;21(1):54-9. doi: 10.4318/tjg.2010.0050.
Extrapulmonary tuberculosis has a poor reputation because of its manifestations. Diagnostic delays or misdiagnosis negatively impact treatment. It has a low incidence and can easily mimic other noninfectious abdominal diseases, which are therefore necessary in the differential diagnosis. We report a 45-year old male presenting with obstructive jaundice, night fever, and abdominal pain and we describe the repeated interesting imaging findings. Imaging techniques revealed an irregularly bordered retroperitoneal mass. Extrapulmonary tuberculosis involvement was diagnosed after laparotomy biopsies. In the case of retroperitoneal mass on imaging techniques, we believe that intraabdominal tuberculosis should be included in the differential diagnosis, especially in endemic areas, in order to avoid unnecessary serious surgical procedures. In this case, we studied serial phase contrast dynamic magnetic resonance imaging of the pancreatic head mass; the complications of hepatic abscess and cholangitis that developed after surgery have never been reported concomitant with tuberculosis disease.
肺外结核因其临床表现而名声不佳。诊断延误或误诊会对治疗产生负面影响。其发病率较低,且容易模仿其他非感染性腹部疾病,因此在鉴别诊断中很有必要。我们报告了一名45岁男性,表现为梗阻性黄疸、夜间发热和腹痛,并描述了反复出现的有趣影像学表现。影像学检查发现一个边界不规则的腹膜后肿块。剖腹探查活检后诊断为肺外结核累及。对于影像学检查发现的腹膜后肿块,我们认为在鉴别诊断中应考虑腹腔结核,尤其是在流行地区,以避免不必要的严重外科手术。在本病例中,我们研究了胰头肿块的系列相位对比动态磁共振成像;术后出现的肝脓肿和胆管炎并发症从未与结核病同时报道过。