Haddad F S, Ghossain A, Sawaya E, Nelson A R
Dis Colon Rectum. 1987 Sep;30(9):724-35. doi: 10.1007/BF02561699.
The recent literature on abdominal tuberculosis is comprehensively reviewed, and seven cases of abdominal tuberculosis are reported, including four belonging to three generations of the same family. Possible explanations for this familial incidence are discussed. Abdominal tuberculosis is not so rare; 135 cases have recently been reported from the United States and Canada. This review dissipates four common misconceptions: abdominal tuberculosis is rare, tuberculosis is a stigmata of the poor, abdominal tuberculosis is always associated with active pulmonary tuberculosis, and chronic abdominal pathology is synonymous with regional enteritis. Since the description of regional enteritis, more and more cases of chronic intestinal pathology have been labeled "regional enteritis." The fact that intestinal tuberculosis is rather uncommon should not automatically lead to the diagnosis of regional enteritis. The possibility that many cases of so-called regional enteritis may, in fact, be a stage or a variant of abdominal tuberculosis, is worth considering. Abdominal tuberculosis is not a relic of the past. It remains a real challenge to the diagnostic acumen and therapeutic skills of both the internist and the surgeon.
对近期有关腹部结核的文献进行了全面综述,并报告了7例腹部结核病例,其中4例属于同一家族的三代人。文中讨论了这种家族发病率的可能原因。腹部结核并非那么罕见;最近美国和加拿大已报告了135例病例。这篇综述消除了四个常见的误解:腹部结核罕见、结核病是穷人的耻辱、腹部结核总是与活动性肺结核相关,以及慢性腹部病变与局限性肠炎同义。自从对局限性肠炎进行描述以来,越来越多的慢性肠道病变被诊断为“局限性肠炎”。肠道结核相当罕见这一事实不应自动导致诊断为局限性肠炎。许多所谓的局限性肠炎病例实际上可能是腹部结核的一个阶段或一种变体,这种可能性值得考虑。腹部结核并非过去的遗留问题。它仍然是对内科医生和外科医生的诊断敏锐度和治疗技能的真正挑战。