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内镜超声在胃肠道及腹部结核中的当前作用

Current role of endoscopic ultrasound for gastrointestinal and abdominal tuberculosis.

作者信息

Maulahela Hasan, Fauzi Achmad, Renaldi Kaka, Srisantoso Qorina P, Jasmine Amirah

机构信息

Division of Gastroenterology, Pancreatobiliary, and Digestive Endoscopy, Internal Medicine Department Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo National Central General Hospital Jakarta Indonesia.

Faculty of Medicine University of Indonesia Jakarta Indonesia.

出版信息

JGH Open. 2022 Sep 30;6(11):745-753. doi: 10.1002/jgh3.12823. eCollection 2022 Nov.

Abstract

A high incidence of tuberculosis (TB), especially in endemic countries, makes this infectious disease a concern. Abdominal TB contributes to 10% of extrapulmonary TB. Due to nonspecific clinical, radiological, and endoscopic findings, diagnosing abdominal TB continues to be a challenge. Hence, a precise diagnosis is needed. The diagnosis of gastrointestinal disease using endoscopic ultrasound (EUS) is often performed due to its high resolution and ability to provide a real-time visual representation of the gastrointestinal tract and extramural structures. EUS-guided fine-needle aspiration (FNA) and fine-needle biopsy (FNB) have helped diagnose TB as they offer an adequate specimen for cytology or histopathological examination. This method is considered safer, more effective, and more efficient. The capacity of EUS to diagnose abdominal TB based on the affected organs was examined via a literature search. We reviewed the role of EUS in diagnosing esophageal, gastric, pancreatic, peripancreatic, hepatosplenic, peritoneal, and intestinal TB. Generally, EUS aids in diagnosing abdominal TB. In some organs, it is superior to other diagnostic modalities. However, further examinations, such as cytology or histopathology and microbial, are still needed. We also studied the roles of EUS-FNA and EUS-FNB. EUS-FNA has shown a high diagnostic yield in esophageal (94.3-100%), pancreatic and peripancreatic (76.2%), and intestinal TB (84.1%). As minimally invasive methods, EUS-FNA and EUS-FNB can successfully provide sufficient samples. EUS is a functional diagnostic modality for abdominal TB. EUS-FNA and EUS-FNB provide sufficient samples safely and efficiently for further cytology, histopathology, and microbial examinations.

摘要

结核病(TB)的高发病率,尤其是在结核病流行国家,使这种传染病备受关注。腹部结核占肺外结核的10%。由于临床、放射学和内镜检查结果不具特异性,腹部结核的诊断仍然是一项挑战。因此,需要进行精确诊断。由于内镜超声(EUS)具有高分辨率,且能够实时直观显示胃肠道及壁外结构,因此常被用于诊断胃肠道疾病。EUS引导下细针穿刺抽吸术(FNA)和细针活检术(FNB)有助于诊断结核病,因为它们能提供足够的样本用于细胞学或组织病理学检查。这种方法被认为更安全、更有效且更高效。通过文献检索,研究了EUS基于受累器官诊断腹部结核的能力。我们回顾了EUS在诊断食管、胃、胰腺、胰周、肝脾、腹膜和肠道结核中的作用。一般来说,EUS有助于腹部结核的诊断。在某些器官中,它优于其他诊断方法。然而,仍需要进一步检查,如细胞学或组织病理学以及微生物学检查。我们还研究了EUS-FNA和EUS-FNB的作用。EUS-FNA在食管结核(94.3%-100%)、胰腺和胰周结核(76.2%)以及肠道结核(84.1%)中显示出较高的诊断率。作为微创方法,EUS-FNA和EUS-FNB能够成功提供足够的样本。EUS是诊断腹部结核的一种功能性诊断方法。EUS-FNA和EUS-FNB能安全、高效地提供足够样本,用于进一步的细胞学、组织病理学和微生物学检查。

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