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[并发肾结核的结肠瘘:一例报告]

[Colorenal fistula complicating renal tuberculosis: a case report].

作者信息

Mejri Ramzi, Chaker Kays, Bibi Mokhtar, Rhouma Sami Ben, Nouira Yassine

机构信息

Service d'Urologie, CHU Mongi Slim la Marsa, Tunis, Tunisie.

Service d´Urologie, Hôpital La Rabta, Tunis, Tunisie.

出版信息

Pan Afr Med J. 2021 Oct 12;40:91. doi: 10.11604/pamj.2021.40.91.30518. eCollection 2021.

Abstract

Urogenital tuberculosis is little suspected and known by clinicians. Colorenal fistulas, although rare, are complex forms of renal tuberculosis occurring in patients with advanced-stage disease. They generally occur in the ascending and descending colon. We here report the clinical case of a 58-year-old female patient presenting to the Emergency Department with severe acute left pyelonephritis. Abdominal CT scan objectified left pyonephrosis with left colorenal fistula. The patient had poor clinical, biological outcome despite resuscitation measures and antibiotic treatments. Urgent left nephrectomy was performed with disconnection and drainage of colorenal fistula. Histology showed renal tuberculosis. The patient received antibacillary drugs according to 2ERHZ/4RH guidelines. The treatment of this type of TB should be adequate to avoid recurrences that could be more complicated to manage.

摘要

泌尿生殖系统结核很少被临床医生怀疑和了解。结肠瘘虽然罕见,但却是晚期肾病患者中肾结核的复杂形式。它们通常发生在升结肠和降结肠。我们在此报告一例58岁女性患者的临床病例,该患者因严重急性左肾盂肾炎就诊于急诊科。腹部CT扫描显示左肾积脓伴左结肠瘘。尽管采取了复苏措施和抗生素治疗,患者的临床和生物学预后仍较差。紧急进行了左肾切除术,并对结肠瘘进行了切断和引流。组织学检查显示为肾结核。患者根据2ERHZ/4RH指南接受了抗结核药物治疗。这类结核病的治疗应足够充分,以避免复发,否则复发后的处理可能会更加复杂。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2edd/8607944/71ee895c2bb9/PAMJ-40-91-g001.jpg

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