Yu V L
Arch Surg. 1977 Oct;112(10):1235-7. doi: 10.1001/archsurg.1977.01370100089019.
The association of tuberculosis after gastrectomy is well documented. Two case reports of tuberculosis developing after jejunoileal bypass for massive obesity are presented, with a review of five previously reported cases. Four of the seven reported patients had tuberculosis infection at extrapulmonary sites. Initial symptoms included fever and acceleration of weight loss. The mean time elapsed from the time of the operation to the diagnosis of tuberculosis was 16 months. Guidelines are given for monitoring patients undergoing jejunoileal bypass with tuberculin skin tests. Indications for isoniazid prophylaxis and multiple drug chemotherapy are given. Serum concentrations of oral antituberculosis drugs must be monitored to ensure adequate absorption.
胃切除术后发生结核病的关联已有充分记录。本文报告了两例因重度肥胖行空肠回肠旁路术后发生结核病的病例，并回顾了此前报告的五例病例。在报告的七例患者中，有四例存在肺外结核感染。初始症状包括发热和体重减轻加速。从手术到结核病诊断的平均时间为16个月。给出了用结核菌素皮肤试验监测接受空肠回肠旁路手术患者的指南。给出了异烟肼预防和联合化疗的指征。必须监测口服抗结核药物的血清浓度以确保充分吸收。
