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晚期腹部结核的外科治疗:一例报告

Abdominal Tuberculosis Managed Surgically in the Late Phase: A Case Report.

作者信息

Fu Ken-Hui, Liaw Geng-Wang

机构信息

Department of Medicine Yee-Zen Hospital Taoyuan Taiwan.

出版信息

J Acute Med. 2020 Mar 1;10(1):40-44. doi: 10.6705/j.jacme.202003_10(1).0005.

Abstract

About 1-5 % of cases of tuberculosis (TB) have uncommon abdominal conditions, and affect primarily young adults. The clinical diagnosis is challenging and often delayed due to the symptoms being non-specific and may be confused with other bowel diseases, therefore resulting in significant morbidity and mortality. A 27-year-old man was brought to our emergency department with the complaints a fever and abdominal pain. According to the chest X-ray findings taken 24 hours previously, pulmonary TB was suspected. Abdominal TB associated intestinal obstruction, ascites and lymphadenopathy were found by computed tomography and exploratory laparotomy. He was treated surgically by segmental resection, however passed away due to severe bleeding caused by the recurrence of perforation of the small intestine and sepsis. This case of systemic TB highlights the difficulties in diagnosis and treatment in time. The early diagnosis and timely treatment are both necessary to manage the disease successfully.

摘要

约1%-5%的结核病(TB)病例有不常见的腹部病症,主要影响年轻人。临床诊断具有挑战性,由于症状不具特异性且可能与其他肠道疾病相混淆,往往会延迟诊断,从而导致显著的发病率和死亡率。一名27岁男性因发热和腹痛被送至我院急诊科。根据24小时前拍摄的胸部X光片结果,怀疑患有肺结核。通过计算机断层扫描和剖腹探查发现腹部结核合并肠梗阻、腹水和淋巴结病。他接受了节段性切除手术治疗,但因小肠穿孔复发和败血症导致严重出血而死亡。这例全身性结核病病例凸显了及时诊断和治疗的困难。早期诊断和及时治疗对于成功控制该病均必不可少。

相似文献

本文引用的文献

1
Abdominal tuberculosis in a low prevalence country.低发病率国家的腹部结核
Med Mal Infect. 2016 May;46(3):140-5. doi: 10.1016/j.medmal.2016.02.003. Epub 2016 Mar 16.
2
Is abdominal tuberculosis a surgical problem?腹部结核是一个外科问题吗?
Ann R Coll Surg Engl. 2015 Sep;97(6):414-9. doi: 10.1308/rcsann.2015.0010. Epub 2015 Aug 14.
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Tuberculous peritonitis: analysis of 211 cases in Taiwan.结核性腹膜炎:台湾 211 例病例分析。
Dig Liver Dis. 2012 Feb;44(2):111-7. doi: 10.1016/j.dld.2011.08.020. Epub 2011 Sep 25.
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Abdominal tuberculosis in southeastern Taiwan: 20 years of experience.台湾东南部的腹部结核:20年经验
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The CT features of abdominal tuberculosis in children.儿童腹部结核的CT特征
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