Patel Nimesh, Ondhia Chandni, Ahmed Shabbir
Orthopaedics Department, East Kent Hospitals NHS Trust, London, Norbury, UK.
BMJ Case Rep. 2011 Nov 1;2011:bcr0620114361. doi: 10.1136/bcr.06.2011.4361.
Tuberculosis is one of the most important communicable diseases worldwide, with an increasing incidence within the UK. The abdomen is involved in 11% of patients with extra-pulmonary tuberculosis, and can provide a diagnostic challenge if not suspected. The authors report the case of a 31-year-old Sudanese female who presented with intestinal obstruction due to a mass caused by abdominal tuberculosis. Imaging revealed evidence of multifocal tuberculosis involving the ileo-caecal region with abdominal and mediastinal lymphadenopathy. She went on to have a limited right hemicolectomy and completed antitubercular therapy. It is important to consider abdominal tuberculosis when conditions such as Crohn's disease or gastrointestinal malignancy are being entertained in those from a high-risk background. Since diagnosis can be difficult, if clinical suspicion is strong, surgery is a safe option. Recommended management combines up to 12 months of antitubercular therapy with conservative surgery.
结核病是全球最重要的传染病之一,在英国其发病率呈上升趋势。腹部受累见于11%的肺外结核患者,若未被怀疑,可能会带来诊断挑战。作者报告了一例31岁苏丹女性病例,该患者因腹部结核所致肿物出现肠梗阻。影像学检查显示回盲部有多灶性结核,伴有腹部和纵隔淋巴结肿大。她接受了有限的右半结肠切除术,并完成了抗结核治疗。对于来自高危背景的人群,当考虑克罗恩病或胃肠道恶性肿瘤等疾病时,必须考虑腹部结核。由于诊断可能困难,若临床怀疑强烈,手术是一种安全选择。推荐的治疗方法是将长达12个月的抗结核治疗与保守手术相结合。