Rojas Christian L, Polanco Evelyn Carolina, Vivar Maria Cecilia, Aguayo William G, Molina Gabriel A, Gutierrez Bernardo M, Cobo Maria M
Grupo Digeslap Center, Quito, Ecuador.
Department of Pathology, Hospital General San Francisco de Quito, Quito, Ecuador.
J Clin Tuberc Other Mycobact Dis. 2020 Jun 23;20:100172. doi: 10.1016/j.jctube.2020.100172. eCollection 2020 Aug.
Tuberculosis (TB) in the gastrointestinal tract or peritoneum is an uncommon condition in clinical practice. Its rarity, combined with its nonspecific presentations, makes this kind of extrapulmonary tuberculosis difficult to diagnose as it can mimic other inflammatory or malignant conditions. Delays in treatment and frequent misdiagnosis can lead to hazardous complications. In countries like Ecuador where the disease is endemic, TB should always be considered in the differential diagnosis of a patients who present with nonspecific abdominal symptoms. In these scenarios, laparoscopy can be an invaluable tool when used with sufficiently high clinical awareness and adequate training.
We present the case of a 37-year-old female patient from Ecuador with a 1-year history of abdominal pain, nausea, intermittent vomits, night sweats, and weight loss. After clinical evaluation and a laparoscopic intervention, abdominal TB was detected and promptly treated. Antituberculosis chemotherapy was initiated, and the patient successfully recovered.
High clinical awareness is imperative when approaching abdominal TB due to its wide spectrum of clinical symptoms and its rarity. Early detection and prompt treatment are critical to minimize the possibility of hazardous complications.
胃肠道或腹膜结核在临床实践中并不常见。其罕见性，再加上非特异性表现，使得这种肺外结核难以诊断，因为它可能与其他炎症或恶性疾病相似。治疗延迟和频繁误诊会导致危险的并发症。在厄瓜多尔等该病为地方病的国家，对于出现非特异性腹部症状的患者进行鉴别诊断时应始终考虑到结核病。在这些情况下，腹腔镜检查若能在具备足够高的临床意识和充分培训的情况下使用，可成为一项非常有价值的工具。
我们介绍一名来自厄瓜多尔的37岁女性患者的病例，该患者有1年的腹痛、恶心、间歇性呕吐、盗汗和体重减轻病史。经过临床评估和腹腔镜干预后，发现了腹部结核并立即进行了治疗。开始进行抗结核化疗，患者成功康复。
由于腹部结核临床症状范围广且罕见，因此在诊治时必须具备高度的临床意识。早期发现和及时治疗对于将危险并发症的可能性降至最低至关重要。
