From the Children's Emergency, KK Women's and Children's Hospital, Singapore.
Department of Radiodiagnosis, Christian Fellowship Hospital, Oddanchatram, Tamilnadu, India.
Pediatr Emerg Care. 2021 Apr 1;37(4):226-229. doi: 10.1097/PEC.0000000000002320.
Tuberculosis of the abdomen is one of the most common extrapulmonary manifestations of tuberculosis. Even in areas where tuberculosis is endemic, intra-abdominal tuberculous can pose a diagnostic and management challenge because of the lack of presence of overt clinical signs and availability of expertise for point of care diagnostics. Point-of-care ultrasound (POCUS) of the abdomen performed by emergency physicians is increasingly being used for a variety of clinical presentations to facilitate accurate diagnoses in the emergency department.
We describe the case of a patient presenting to the pediatric emergency department with acute abdominal pain, in whom POCUS helped expedite the diagnosis of abdominal tuberculosis.
In the right clinical setting, the concurrent presence of intra-abdominal lymphadenopathy, ascites, mesenteric thickening, ileocecal thickening, and splenic microabscesses on ultrasound imaging should lead to consideration of the diagnosis of intra-abdominal tuberculosis. Although typically diagnosed on computed tomography or magnetic resonance imaging, in our case, POCUS helped facilitate the bedside diagnosis of abdominal tuberculosis in the emergency department.
腹部结核是最常见的肺外结核表现之一。即使在结核病流行的地区，由于缺乏明显的临床症状和即时诊断专家，腹腔内结核也可能构成诊断和治疗管理的挑战。由急诊医师进行的腹部即时超声检查（POCUS）越来越多地用于各种临床表现，以在急诊科协助准确诊断。
我们描述了一位因急性腹痛就诊于儿科急诊的患者，POCUS 有助于加速腹部结核的诊断。
在适当的临床环境中，超声图像上同时存在腹腔内淋巴结病、腹水、肠系膜增厚、回盲部增厚和脾脏小脓肿，应考虑腹腔内结核的诊断。虽然通常通过计算机断层扫描或磁共振成像进行诊断，但在我们的病例中，POCUS 有助于在急诊科床边诊断腹部结核。
