疑似克罗恩病的肠结核病例。
Case of intestinal tuberculosis mimicking Crohn's disease.
作者信息
Foster Brock D, Buchberg Brian, Parekh Nimisha K, Mills Steven
机构信息
Department of Surgery, University of California, Irvine Medical Center, Orange, CA, U.S.A.
出版信息
Am J Case Rep. 2012;13:58-61. doi: 10.12659/AJCR.882756. Epub 2012 May 11.
BACKGROUND
Intestinal tuberculosis can closely mimic Crohn's disease and colon cancer. Presented here is a case of intestinal tuberculosis that closely mimicked both.
CASE REPORT
A 23 year old Hispanic female presented with several months of weight loss, recurrent fever, and emesis. The patient did not have pulmonary symptoms or radiographic evidence of tuberculosis. Colonoscopy evaluation with biopsy of the affected bowel segments were thought to be consistent with either colon cancer or Crohn's Disease. Acid fast bacilli staining and histological analysis did not display evidence of tuberculosis on two separate occasions. The patient developed colonic obstruction acutely during the course of treatment requiring resection of the affected bowel segment. Acid fast staining of the resected lymph nodes was positive and submucosal caseating granulomas were identified histologically, consistent with intestinal tuberculosis.
CONCLUSIONS
Intestinal tuberculosis remains a diagnostic challenge. Consideration of the disease should be maintained in equivocal cases.
背景
肠结核可与克罗恩病和结肠癌极为相似。本文介绍了一例酷似这两种疾病的肠结核病例。
病例报告
一名23岁的西班牙裔女性出现数月体重减轻、反复发热和呕吐症状。该患者没有肺部症状，也没有结核病的影像学证据。结肠镜检查及对受累肠段进行活检，结果被认为与结肠癌或克罗恩病相符。抗酸杆菌染色及组织学分析在两个不同时间均未显示结核病迹象。患者在治疗过程中急性发生结肠梗阻，需要切除受累肠段。切除的淋巴结抗酸染色呈阳性，组织学检查发现黏膜下干酪样肉芽肿，符合肠结核表现。
结论
肠结核仍然是一个诊断难题。在诊断不明确的病例中应考虑该病。
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