Department of Gastroenterology, HangZhou Xixi Hospital, HangZhou, Zhejiang, China.
J Int Med Res. 2024 Aug;52(8):3000605241272702. doi: 10.1177/03000605241272702.
The widespread occurrence and severity of tuberculosis make it a major global health concern. Abdominal issues often affect the intestine, peritoneum, and lymph nodes, with retroperitoneal involvement being rare. We herein present a case involving a 51-year-old man who experienced abdominal pain and fever. He had a history of pulmonary tuberculosis 1 year prior, which had been cured 6 months before presentation to our hospital. Abdominal unenhanced computed tomography revealed incomplete bowel obstruction. Abdominal enhanced computed tomography showed significant enlargement of the retroperitoneal lymph nodes, which were compressing the intestinal lumen. Colonoscopy indicated that the terminal ileum and colon were normal. Ultrasound-guided percutaneous lymph node aspiration was performed, and fluorescence staining was positive. After anti-tuberculosis treatment, the patient's abdominal pain and fever improved. Retroperitoneal lymph node tuberculosis presents atypically, and obtaining histopathology early is therefore crucial for diagnosis and treatment.
结核病的广泛发生和严重性使其成为一个主要的全球卫生关注问题。腹部问题常影响肠道、腹膜和淋巴结,而腹膜后受累则较为罕见。我们在此报告一例 51 岁男性,他出现腹痛和发热。他在 1 年前患有肺结核,在来我院就诊前 6 个月已治愈。腹部未增强 CT 显示不完全性肠梗阻。腹部增强 CT 显示腹膜后淋巴结显著肿大,压迫肠腔。结肠镜检查提示末端回肠和结肠正常。行超声引导下经皮淋巴结抽吸术,荧光染色阳性。抗结核治疗后,患者腹痛和发热改善。腹膜后淋巴结结核表现不典型,因此早期获取组织病理学对诊断和治疗至关重要。