Ionescu Sinziana, Nicolescu Alin Codrut, Madge Octavia Luciana, Marincas Marian, Radu Madalina, Simion Laurentiu
1st Clinic of General Surgery and Surgical Oncology, Bucharest Oncology Institute, 022328 Bucharest, Romania.
Department of Surgery, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Diagnostics (Basel). 2021 Dec 15;11(12):2362. doi: 10.3390/diagnostics11122362.
Tuberculosis (TB) is a public health issue that affects mostly, but not exclusively, developing countries. Abdominal TB is difficult to detect at first, with the incidence ranging from 10% to 30% of individuals with lung TB. Symptoms are non-specific, examinations can be misleading, and biomarkers commonly linked with other diseases can also make appropriate diagnosis difficult. As a background for this literature review, the method used was to look into the main characteristics and features of abdominal tuberculosis that could help with differentiation on the PubMed, Science Direct, and Academic Oxford Journals databases. The results were grouped into three categories: A. general features (the five forms of abdominal tuberculosis: wet and dry peritonitis, lymphadenopathy, lesions at the level of the cavitary organs, lesions at the level of the solid organs), B. different intra-abdominal organs and patterns of involvement (oesophageal, gastro-duodenal, jejunal, ileal, colorectal, hepatosplenic, and pancreatic TB with calcified lymphadenopathy, also with description of extraperitoneal forms), and C. special challenges of the differential diagnosis in abdominal TB (such as diagnostic overlap, the disease in transplant candidates and transplant recipients, and zoonotic TB). The study concluded that, particularly in endemic countries, any disease manifesting with peritonitis, lymphadenopathy, or lesions at the level of the intestines or solid organs should have workups and protocols applied that can confirm/dismiss the suspicion of abdominal tuberculosis.
结核病是一个主要但并非仅仅影响发展中国家的公共卫生问题。腹部结核起初难以检测，其发病率在肺结核患者中占10%至30%。症状不具特异性，检查可能会产生误导，而且通常与其他疾病相关的生物标志物也会使准确诊断变得困难。作为本次文献综述的背景，所采用的方法是在PubMed、Science Direct和牛津学术期刊数据库中研究有助于鉴别腹部结核的主要特征。结果分为三类：A. 一般特征（腹部结核的五种形式：湿性和干性腹膜炎、淋巴结病、空腔脏器层面的病变、实性脏器层面的病变），B. 不同的腹腔内器官及受累模式（食管、胃十二指肠、空肠、回肠、结肠直肠、肝脾和胰腺结核伴钙化淋巴结病，还描述了腹膜外型），以及C. 腹部结核鉴别诊断的特殊挑战（如诊断重叠、移植候选者和移植受者中的疾病以及人畜共患结核病）。该研究得出结论，特别是在流行国家，任何表现为腹膜炎、淋巴结病或肠道或实性脏器层面病变的疾病都应采用能够确认/排除腹部结核疑似病例的检查方法和方案。
