Kubota H, Ageta M, Kubo H, Wada S, Nagamachi S, Yamanaka T
Department of Internal Medicine, Miyazaki Prefectural Nichinan Hospital.
Intern Med. 1994 Jun;33(6):351-6. doi: 10.2169/internalmedicine.33.351.
Tuberculous liver abscess has been reported in only fourteen patients in Japan and in twenty-nine patients outside Japan. Only nine of the non-Japanese patients and none of the Japanese patients have been treated for this condition without laparotomy. We report a patient who developed tuberculous liver abscess during treatment of tuberculous peritonitis. Diagnosis was made by ultrasound-guided aspiration biopsy, and the patient was treated with percutaneous drainage and transcatheter infusion of antituberculous agents. Direct infusion of antituberculous agents has more direct effects in the treatment of an abscess than systemic chemotherapy alone. Therefore, if a percutaneous catheter can be safely placed, the use of transcatheter infusion of antituberculous agents should be considered.
在日本,仅有14例患者被报道患有结核性肝脓肿,在日本以外地区有29例。在非日本患者中,只有9例未经剖腹手术就接受了这种疾病的治疗,而日本患者中无一例如此。我们报告了一名在结核性腹膜炎治疗期间发生结核性肝脓肿的患者。通过超声引导下穿刺活检进行诊断,该患者接受了经皮引流和经导管注入抗结核药物的治疗。与单纯全身化疗相比,直接注入抗结核药物在脓肿治疗中具有更直接的效果。因此,如果能够安全地放置经皮导管,应考虑使用经导管注入抗结核药物。