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原发性胃十二指肠结核并发急性胰腺炎:一例罕见病例报告并文献复习。

Primary gastroduodenal tuberculosis complicated with acute pancreatitis: a rare case report and literature review.

机构信息

Department of Gastroenterology, Tungwah Hospital of Sun Yat-Sen University, Dongguan, Guangdong, China.

出版信息

Eur J Med Res. 2020 Dec 7;25(1):65. doi: 10.1186/s40001-020-00468-5.

Abstract

BACKGROUND

Tuberculosis (TB) is a major health problem worldwide. Even in highly prevalent countries, primary gastroduodenal tuberculosis is a rare manifestation of extrapulmonary tuberculosis. In recent years, as the incidence of tuberculosis has increased year by year, the occur of gastroduodenal tuberculosis has also increased. Endoscopy is an important tool for diagnosing gastroduodenal tuberculosis. The performance of gastroduodenal tuberculosis under endoscopy is often non-specific, which may imitate other benign or malignant gastroduodenal diseases. Diagnosis of gastroduodenal tuberculosis relies on a combination of endoscopy and guided biopsy.

CASE PRESENTATION

Here, we report a rare and interesting case of gastroduodenal tuberculosis with acute pancreatitis. The case initially mimicked gastroduodenal ulcers in morphology and appeared in a middle-aged person with normal immunity but with prolonged fever and abdominal pain. The disease was diagnosed through endoscopy and guided biopsy, and it responded well to antituberculosis drugs.

CONCLUSIONS

Clinicians must remember that even in the absence of immunodeficiency, as in this case, tuberculosis can affect any part of the gastrointestinal tract.

摘要

背景

结核病(TB)是全球范围内的一个主要健康问题。即使在高流行国家,原发性胃十二指肠结核也是肺外结核的罕见表现。近年来,随着结核病发病率逐年上升,胃十二指肠结核的发生也有所增加。内镜检查是诊断胃十二指肠结核的重要工具。胃十二指肠结核的内镜表现通常是非特异性的,可能模仿其他良性或恶性胃十二指肠疾病。胃十二指肠结核的诊断依赖于内镜和引导活检的结合。

病例介绍

在这里,我们报告了一例罕见且有趣的胃十二指肠结核伴急性胰腺炎病例。该病例最初在形态上类似于胃十二指肠溃疡,发生在一名中年免疫功能正常但长期发热和腹痛的患者中。通过内镜和引导活检进行诊断,该病例对抗结核药物反应良好。

结论

临床医生必须记住,即使在没有免疫缺陷的情况下,如本例中,结核病也可能影响胃肠道的任何部位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/166e/7720629/2aecb0310646/40001_2020_468_Fig1_HTML.jpg

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本文引用的文献

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Gastroduodenal Tuberculosis: A Case Series and Review of Literature.胃十二指肠结核:病例系列及文献综述
Clin Med Insights Gastroenterol. 2018 Jul 30;11:1179552218790566. doi: 10.1177/1179552218790566. eCollection 2018.
5
Primary gastric tuberculosis mimicking gastric cancer.酷似胃癌的原发性胃结核。
Ulus Cerrahi Derg. 2015 Sep 1;31(3):177-9. doi: 10.5152/UCD.2014.2667. eCollection 2015.
6
Abdominal tuberculosis of the gastrointestinal tract: revisited.胃肠道结核:再探讨
World J Gastroenterol. 2014 Oct 28;20(40):14831-40. doi: 10.3748/wjg.v20.i40.14831.
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Gastric tuberculosis.胃结核
Br Med J. 1960 Oct 29;2(5208):1288-90. doi: 10.1136/bmj.2.5208.1288.

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