Lingenfelser T, Zak J, Marks I N, Steyn E, Halkett J, Price S K
Department of Medicine, Groote Schuur Hospital, Cape Town, South Africa.
Am J Gastroenterol. 1993 May;88(5):744-50.
The findings in a 4-yr survey of 82 patients with abdominal tuberculosis are described and compared with those encountered in previous surveys. Fourteen cases of intestinal, 11 of mesenteric-lymphnodal, and 57 of peritoneal tuberculosis were identified. The disease occurred essentially in patients living under worsening socioeconomic conditions, and 51 of them had associated pulmonary tuberculosis. Symptoms and clinical findings were again nonspecific, but newer imaging, endoscopic, and other invasive procedures were helpful in establishing a definite diagnosis. In addition, adenosine deaminase determination showed great promise as a noninvasive diagnostic procedure in patients with tuberculous ascites. The six hospital deaths in the series highlight the hazard of potentially lethal delays in early diagnosis and treatment, even in centers with a high awareness of the disease.
本文描述了对82例腹部结核患者进行的为期4年的调查结果，并与之前调查中的结果进行了比较。确定了14例肠结核、11例肠系膜淋巴结结核和57例结核性腹膜炎。该病主要发生在社会经济状况不断恶化的患者中，其中51例伴有肺结核。症状和临床发现仍然不具有特异性，但新的影像学、内镜及其他侵入性检查方法有助于明确诊断。此外，腺苷脱氨酶测定作为结核性腹水患者的一种非侵入性诊断方法显示出很大的前景。该系列中有6例患者在医院死亡，这突出了即使在对该病认识较高的中心，早期诊断和治疗中潜在致命延误的风险。
