Taniyama Daisuke, Hirao Maki, Kobuna Mika, Yuda Sayako, Kitahara Mitsuo
Kansenshogaku Zasshi. 2014 Mar;88(2):171-5. doi: 10.11150/kansenshogakuzasshi.88.171.
We report herein on a case of the primary intestinal tuberculosis in which small intestine perforation developed. A 60-year-old man with congestive heart failure developed fever and sudden onset of abdominal pain while he was in the hospital. Computed tomography of the abdomen showed a large amount of free-air and the thickening of a part of the ileum. Perforation of the gastrointestinal tract was diagnosed, The patient underwent emergency exploratory laparotomy and a partial resection of the ileum was performed. The presence of nodules in the ileum suggested possible tuberculosis of the intestine. Pathologically caseating epithelioid granulomas were noted and the diagnosis of tuberculosis of the ileum was made although microbiologically tuberculous bacilli were not documented. The patient was successfully treated with antituberculosis chemotherapy. Although intestinal tuberculosis is a rare cause of intestinal perforation, it is important to include intestinal tuberculosis as one of the cases.
我们在此报告一例发生小肠穿孔的原发性肠结核病例。一名60岁充血性心力衰竭男性患者住院期间出现发热及突发腹痛。腹部计算机断层扫描显示大量游离气体及部分回肠增厚。诊断为胃肠道穿孔,患者接受了急诊剖腹探查术并进行了回肠部分切除术。回肠中存在结节提示可能为肠结核。病理检查发现干酪样上皮样肉芽肿,虽微生物学检查未发现结核杆菌,但仍确诊为回肠结核。该患者接受抗结核化疗后成功治愈。尽管肠结核是肠穿孔的罕见病因,但将肠结核纳入病例之一很重要。