University of Ottawa, Ottawa, Ontario.
Tuberculosis Programme, Division of Respirology, Department of Medicine.
Int J Tuberc Lung Dis. 2018 Jun 1;22(6):681-685. doi: 10.5588/ijtld.17.0685.
To describe the experience with abdominal tuberculosis (TB), including potential risk factors, presentation, diagnosis, treatment and clinical course, at one Canadian clinic.
This was a retrospective case series of all patients with abdominal TB (excluding the genito-urinary system and abdominal muscle) who received care at the Saint Michael's Hospital TB Clinic (Toronto, ON, Canada) from April 2003 to July 2016.
Of 590 active TB cases encountered between April 2003 and July 2016, 24 (4.1%) had abdominal TB. All cases were foreign-born, and over 50% occurred among individuals who were not recent immigrants. Background abdominal illnesses and immunocompromised health status were rarely seen. Lymphadenitis (58.3%) and the peritoneum (41.7%) were the most common forms of abdominal TB, bowel involvement was infrequent and most had concomitant extra-abdominal disease (62.5%). All cases were cured, largely using ⩾9 months of pharmacotherapy. Gastrointestinal intolerance and liver dysfunction were rarely observed side effects of therapy.
Several traditional TB risk factors occurred infrequently among our cases, which highlights the importance of having a low threshold for considering abdominal TB in the appropriate clinical setting. Although abdominal TB often occurred in the context of disseminated disease, cure was achievable, but ⩾9 months of treatment may generally be needed.
描述一家加拿大诊所的腹部结核（TB）的诊治经验，包括潜在的危险因素、临床表现、诊断、治疗和临床经过。
这是一项回顾性病例系列研究，纳入了 2003 年 4 月至 2016 年 7 月在圣迈克尔医院结核诊所（加拿大安大略省多伦多市）就诊的所有腹部 TB（不包括生殖泌尿系统和腹部肌肉）患者。
2003 年 4 月至 2016 年 7 月期间共发现 590 例活动性 TB 患者，其中 24 例（4.1%）为腹部 TB。所有患者均为移民，50%以上的患者并非近期移民。既往有腹部疾病和免疫功能低下的患者少见。淋巴结炎（58.3%）和腹膜（41.7%）是最常见的腹部 TB 形式，肠受累少见，大多数患者伴有其他腹外疾病（62.5%）。所有患者均治愈，主要采用了 ⩾9 个月的药物治疗。胃肠道不耐受和肝功能障碍很少见。
在我们的病例中，一些传统的 TB 危险因素很少见，这突出了在适当的临床环境下对腹部 TB 保持低阈值的重要性。尽管腹部 TB 常发生在播散性疾病的背景下，但可治愈，但通常需要 ⩾9 个月的治疗。
