Konstantara Filitsa, Stamopoulou Sotiria, Gkegkes Ioannis D, Kotrogiannis Ioannis, Fotiou Eleftherios, Papazacharias Christos, Paraskevopoulos Ioannis A, Filippou Dimitrios, Skandalakis Panagiotis
First Department of Surgery, General Hospital of Attica "KAT," Athens, Greece.
Department of Anatomy and Surgical Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
SAGE Open Med Case Rep. 2019 Apr 28;7:2050313X19844379. doi: 10.1177/2050313X19844379. eCollection 2019.
Tuberculosis used to be uncommon in the developed countries but seems to be still on rampant in developing countries. However, there seems to be an increasing occurrence in the developed countries too mainly due to low living conditions, increased migration, HIV immune-compromisation and inappropriate use of antitubercular drugs. Lymphatic tuberculosis is the second commonest extrapulmonary location of tuberculosis followed by genitourinary, bone and joint, miliary, meningeal and abdominal. Abdominal tuberculosis represents nearly 11%-16% of all extrapulmonary tuberculosis locations. Furthermore, abdominal tuberculosis co-exists with pulmonary tuberculosis in 10%-30% of patients. Abdominal tuberculosis remains difficult to diagnose due to non-specific symptoms, variable anatomical locations and lack of specific sensitive diagnostic tools. Diagnosis can be rarely suspected, especially in cases of isolated abdominal tuberculosis without clinical or radiological findings. We present a rare case of a patient with pulmonary tuberculosis combined with intra-abdominal lymphatic tuberculosis causing small intestine volvulus.
结核病在发达国家曾经并不常见，但在发展中国家似乎仍很猖獗。然而，发达国家的发病率似乎也在上升，主要原因是生活条件差、移民增加、艾滋病毒免疫功能受损以及抗结核药物使用不当。淋巴结核是结核病肺外第二常见的部位，其次是泌尿生殖系统、骨骼和关节、粟粒性、脑膜和腹部。腹部结核占所有肺外结核部位的近11%-16%。此外，10%-30%的患者腹部结核与肺结核并存。由于症状不具特异性、解剖位置多变以及缺乏特异性敏感的诊断工具，腹部结核仍然难以诊断。很少能怀疑到诊断，尤其是在没有临床或影像学表现的孤立性腹部结核病例中。我们报告一例罕见病例，一名患有肺结核合并腹腔内淋巴结核导致小肠扭转的患者。
