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肠结核:诊断难题——病例报告及文献复习。

Intestinal tuberculosis: a diagnostic challenge--case report and review of the literature.

机构信息

First Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA General Hospital, Thessaloniki, Greece.

出版信息

Eur J Gastroenterol Hepatol. 2011 Nov;23(11):1074-7. doi: 10.1097/MEG.0b013e32834a9470.

Abstract

Even though tuberculosis is considered rare in developed countries, its rising incidence, especially in high-risk populations, places intestinal tuberculosis in the differential diagnosis of patients with atypical abdominal symptoms or signs. We, herein, report the case of an immunocompetent woman, from a nonendemic area, who developed intestinal tuberculosis, emphasizing the diagnostic challenges caused due to nonspecific symptoms, inconclusive clinical, laboratory, and imaging findings, which could not rule in or rule out tuberculosis. Antituberculosis treatment was administered based on endoscopic findings and histological features of mucosal biopsies, which were indicative of intestinal tuberculosis, and the patient showed a marked clinical and laboratory improvement. We also review the evidence with regard to the diagnostic accuracy of the different available tests for intestinal tuberculosis.

摘要

尽管结核病在发达国家被认为较为罕见,但由于其发病率上升,尤其是在高危人群中,因此将肠结核纳入有非典型腹部症状或体征的患者的鉴别诊断中。在此,我们报告了一例来自非流行地区的免疫功能正常的女性发生肠结核的病例,强调了由于非特异性症状、临床、实验室和影像学检查结果不确定而导致的诊断挑战,这些结果无法确定或排除结核病。根据内镜检查结果和黏膜活检的组织学特征给予抗结核治疗,提示肠结核,患者的临床和实验室情况明显改善。我们还回顾了不同可用的肠结核检测方法的诊断准确性的证据。

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