Hurtado Caballero E, Mercader Cidoncha E, Ruiz de la Hermosa A, Amunategui Prats I, Maldonado Valdivieso P, Muñoz-Calero Peregrín A
Acta Gastroenterol Latinoam. 2015 Dec;45(4):316-9.
Tuberculosis is the commonest cause of spinal infection worldwide (9-46%). Tuberculosis spondylodiscitis causes multifocal thoracic and lumbar spinal disease, and big paraspinal and psoas abscesses. It is more frequent in people under 40 who had previous tuberculosis infection and from countries where the illness is endemic. Clinic is non-specific and sub-acute. We report the clinical case of a 29-year-old patient who suffered from pericardic tuberculosis in her childhood and who presents a bilateral retroperitoneal abscess due to tuberculosis spondylodiscitis. Her clinical debut began with left inguinal pain and an irreducible mass at this level that simulated an incarcerated inguinal hernia, which is why surgery was indicated. Due to discrepancies between intraoperative findings and the initial diagnosis, the diagnosis and treatment strategy were changed. The purpose of this case report is to emphasize the challenge that the diagnosis of this pathology represents, due to low incidence in our environment and poor clinical features, which results in late diagnosis and late management.
结核病是全球脊柱感染最常见的病因（9%-46%）。结核性脊椎间盘炎可导致多灶性胸腰椎疾病以及巨大的椎旁和腰大肌脓肿。在既往有结核感染的40岁以下人群以及结核病流行国家的人群中更为常见。临床表现无特异性且呈亚急性。我们报告一例29岁患者的临床病例，该患者童年时患有心包结核，现因结核性脊椎间盘炎出现双侧腹膜后脓肿。她的临床首发症状是左侧腹股沟疼痛以及该部位出现一个无法回纳的肿块，类似嵌顿性腹股沟疝，因此当时建议进行手术。由于术中发现与初步诊断不符，诊断和治疗策略发生了改变。本病例报告的目的是强调这种疾病诊断所面临的挑战，因为在我们所处环境中发病率低且临床特征不典型，导致诊断延迟和治疗滞后。
