Rafael Maria Ana, Martins Figueiredo Luísa, Oliveira Ana Maria, Nuno Costa Mariana, Theias Manso Rita, Martins Alexandra
Gastroenterology Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal.
Pathologic Anatomy Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal.
GE Port J Gastroenterol. 2020 Jul;27(4):278-282. doi: 10.1159/000504719. Epub 2019 Dec 13.
We present the case of a 24-year-old woman with complaints of abdominal pain, bloody diarrhea, and weight loss for 3 months. An outpatient colonoscopy revealed scattered ulcers, suggestive of Crohn's disease (CD). Histopathology also favored the diagnosis of CD. However, after admission to our hospital for further investigation, a chest radiograph revealed pulmonary cavitations. A computed tomography scan suggested the diagnosis of active pulmonary tuberculosis (TB). Therefore, a bronchofibroscopy, a total colonoscopy with ileoscopy, and an upper endoscopy were performed. Not only were acid-fast bacilli present in both bronchoalveolar lavage fluid and gastric juice, but also in colonic biopsies. A complete resolution of gastrointestinal symptoms was achieved 2 weeks after starting anti-TB drugs.
我们报告了一例24岁女性患者，她有腹痛、血性腹泻和体重减轻3个月的症状。门诊结肠镜检查发现散在溃疡，提示克罗恩病（CD）。组织病理学也支持CD的诊断。然而，在我院住院进一步检查后，胸部X线片显示肺部有空洞。计算机断层扫描提示活动性肺结核（TB）的诊断。因此，进行了支气管纤维镜检查、全结肠镜检查及回肠镜检查和上消化道内镜检查。不仅在支气管肺泡灌洗液和胃液中发现了抗酸杆菌，在结肠活检组织中也发现了抗酸杆菌。开始抗结核药物治疗2周后，胃肠道症状完全缓解。
