Michalopoulos Antonis, Papadopoulos Vassilis N, Panidis Stavros, Papavramidis Theodossis S, Chiotis Anastasios, Basdanis George
First Propedeutic Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
J Med Case Rep. 2011 Mar 30;5:128. doi: 10.1186/1752-1947-5-128.
Primary intestinal tuberculosis is a rare variant of tuberculosis. The preferred treatment is usually pharmaceutical, but surgery may be required for complicated cases.
We report two cases of primary intestinal tuberculosis where the initial diagnosis was wrong, with colonic cancer suggested in the first case and a Crohn's disease complication in the second. Both of our patients were Caucasians of Greek nationality. In the first case (a 60-year-old man), a right hemicolectomy was performed. In the second case (a 26-year-old man), excision was impossible due to the local conditions and peritoneal implantations. Histopathology revealed an inflammatory mass of tuberculous origin in the first case. In the second, cell culture and polymerase chain reaction tests revealed Mycobacterium tuberculosis. Both patients were given anti-tuberculosis therapy and their post-operative follow-up was uneventful.
Gastrointestinal tuberculosis still appears sporadically and should be considered in the differential diagnosis along with other conditions of the bowel. The use of immunosuppressants and new pharmaceutical agents can change the prevalence of tuberculosis.
原发性肠结核是结核病的一种罕见类型。首选治疗通常是药物治疗,但复杂病例可能需要手术。
我们报告两例原发性肠结核病例,最初诊断有误,第一例提示为结肠癌,第二例提示为克罗恩病并发症。我们的两名患者均为希腊籍白种人。第一例(一名60岁男性)行右半结肠切除术。第二例(一名26岁男性)因局部情况和腹膜种植无法进行切除。组织病理学检查在第一例中显示为结核源性炎性肿块。在第二例中,细胞培养和聚合酶链反应检测显示为结核分枝杆菌。两名患者均接受抗结核治疗,术后随访情况良好。
胃肠道结核仍偶有出现,在鉴别诊断中应与肠道的其他疾病一并考虑。免疫抑制剂和新型药物的使用会改变结核病的发病率。