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以结肠狭窄为表现的左侧结肠结核:一种常见疾病的罕见表现

Left-Sided Colonic Tuberculosis Presenting as Colonic Stricture: A Rare Presentation of a Common Disease.

作者信息

Abdul Jabbar Shabana, Selvakumar B, Varshney Vaibhav Kumar, Sharma Indu, Khera Sudeep, Hussain Sabir

机构信息

Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Department of Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

出版信息

ACG Case Rep J. 2022 Nov 24;9(11):e00928. doi: 10.14309/crj.0000000000000928. eCollection 2022 Nov.

Abstract

Gastrointestinal tuberculosis (TB) mainly presents as an ileocecal disease, and colonic TB is more often seen with terminal ileal involvement. Isolated involvement of the descending colon by TB is uncommon and usually presents with chronic colitis. An acute presentation as intestinal obstruction because of tubercular stricture of the descending colon has not been reported. We encountered a young woman who presented with features of acute bowel obstruction. On evaluation, she was diagnosed with a case of descending colon stricture with a provisional diagnosis of malignant colonic stricture. Left hemicolectomy was performed, and histopathology revealed it to be tubercular stricture. Antitubercular therapy was given for 9 months, and she is doing well at follow-up. A differential diagnosis of TB at an unusual location should always be considered even when presented with atypical symptoms, especially for patients from the endemic zone of TB.

摘要

胃肠道结核(TB)主要表现为回盲部疾病,结肠结核更常伴有回肠末端受累。结核孤立累及降结肠并不常见,通常表现为慢性结肠炎。尚未有因降结肠结核性狭窄而急性表现为肠梗阻的报道。我们遇到一名年轻女性,她表现出急性肠梗阻的特征。经评估,她被诊断为降结肠狭窄,初步诊断为恶性结肠狭窄。进行了左半结肠切除术,组织病理学显示为结核性狭窄。给予抗结核治疗9个月,随访时她情况良好。即使出现非典型症状,尤其是对于来自结核病流行区的患者,也应始终考虑不寻常部位结核的鉴别诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42a9/9699644/4175672568f2/ac9-9-e00928-g001.jpg

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