Mounadif M, Badre W, Elamraoui F, Hamdani A, Mourid A, Biadillah M C, Jamil D, Cherkaoui A
Service de Gastroentérologie et Proctologie A, CHU Ibn Rochd, Casablanca, Moroc.
Ann Gastroenterol Hepatol (Paris). 1995 May-Jun;31(3):145-9.
The authors report a retrospective study of 27 cases of "ileo-caecal tuberculosis" collected over a period of 10-years. Sixteen women and eleven men, between 14 and 55 years of age (with a group mean age of 28 years), were included. This is still a common disease in Morocco, despite attempts to achieve universal BCG vaccination. Diarrhoea, abdominal pain and a general physical deterioration are the most indicative signs, but are not specific. Tests for M. tuberculosis hominis are often negative, except in cases in which bacteria proliferate in pulmonary excavations, and this makes it difficult to establish a definite diagnosis. The detection of narrowing of the ileum or colon in a country where infection is endemic suggests the possibility of tuberculosis. Colonoscopy, which is becoming increasingly widespread in Morocco, makes an essential contribution. Although it is rare for caseum to be detected in biopsy fragments, the main value of histopathology is that it can eliminate cancer, making it possible to start antibacterial treatment without a diagnostic laparotomy. The outcome of medical treatment is nearly always positive. Clinical improvement, bacteriology tests and X-ray examinations are criteria that a cure has been obtained.
作者报告了一项对10年间收集的27例“回盲部结核”病例的回顾性研究。研究纳入了16名女性和11名男性，年龄在14岁至55岁之间（平均年龄28岁）。尽管摩洛哥已尝试普及卡介苗接种，但回盲部结核仍是该国的常见疾病。腹泻、腹痛和全身身体状况恶化是最具指示性的症状，但并不具有特异性。人型结核分枝杆菌检测通常为阴性，除非细菌在肺部空洞中增殖，这使得明确诊断变得困难。在感染流行的国家，回肠或结肠狭窄的发现提示了患结核病的可能性。结肠镜检查在摩洛哥越来越普遍，发挥了重要作用。虽然在活检碎片中很少能检测到干酪样物质，但组织病理学的主要价值在于它可以排除癌症，从而无需进行诊断性剖腹手术即可开始抗菌治疗。药物治疗的结果几乎总是积极的。临床改善、细菌学检测和X线检查是已治愈的标准。
