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腹膜结核导致的小肠梗阻

Small Bowel Obstruction As a Consequence of Peritoneal Tuberculosis.

作者信息

Shams Amir Hossein, Niakan Mohammad Hadi, Ahadi Mahsa, Rasekhinejad Majid, Sardar Kermani Samane

机构信息

Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Bull Emerg Trauma. 2022;10(4):196-200. doi: 10.30476/BEAT.2021.91273.1277.

Abstract

Peritoneal tuberculosis (PTB) is a rare subset of extrapulmonary tuberculosis which account for only 0.5-1% of all cases. PTB diagnosis can be challenging due to nonspecific clinical manifestations. We present a known case of pulmonary tuberculosis that admitted to the surgery ward due to the major complaint of abdominal pain since ten days before admission. In imaging studies, positive findings favoring mechanical obstruction were detected. There were also several hypodense lesions in the liver suggestive of visceral tuberculosis. An adhesion was noted during exploratory laparotomy prior to the ileocecal valve responsible for intestinal obstruction, which was released. Pathology reports of excised tissues were consonant with the PTB diagnosis. PTB diagnosis can be challenging because of its presentation. This can delay the treatment of patients and thus increase morbidity and mortality. As a result, physicians should always be aware of the PTB diagnosis in patients with nonspecific abdominal involvement.

摘要

腹膜结核(PTB)是肺外结核中较为罕见的一种类型,仅占所有病例的0.5%-1%。由于临床表现不具特异性,PTB的诊断颇具挑战性。我们报告一例已知的肺结核病例,该患者因入院前10天以来的主要诉求——腹痛而入住外科病房。在影像学检查中,发现了提示机械性梗阻的阳性结果。肝脏中还存在多个低密度病变,提示内脏结核。在探查性剖腹手术中,发现回盲瓣之前存在一处导致肠梗阻的粘连,遂予以松解。切除组织的病理报告与PTB诊断相符。PTB因其表现形式而诊断困难。这可能会延误患者的治疗,从而增加发病率和死亡率。因此,医生应始终留意非特异性腹部受累患者的PTB诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96c2/9758706/f354b52cedb5/bet-10-196-g001.jpg

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