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非免疫功能低下患者的胰腺结核:两例报告及文献综述

Pancreatic tuberculosis in non-immunocompromised patients: reports of two cases, and a literature review.

作者信息

Ladas S D, Vaidakis E, Lariou C, Anastasiou K, Chalevelakis G, Kintzonidis D, Raptis S A

机构信息

Second Department of Internal Medicine, Evangelismos Hospital, Athens University, Greece.

出版信息

Eur J Gastroenterol Hepatol. 1998 Nov;10(11):973-6. doi: 10.1097/00042737-199811000-00013.

Abstract

We present two cases of biopsy proven tuberculosis of the pancreas in non-immunocompromised patients diagnosed and treated in our unit within the last 14 years. The first case presented with abdominal pain and fever, and the second with iron deficiency anaemia and severe weight loss. In both cases abdominal ultrasound and computed tomography suggested a pancreatic carcinoma. There was no pulmonary or intestinal tuberculosis. The tuberculin skin test was positive. Upon exploratory laparotomy the macroscopic appearance of the pancreas was that of an inoperable pancreatic carcinoma. Following the histological diagnosis of pancreatic tuberculosis, both patients were successfully treated with triple antituberculous therapy for 6 months. Isolated pancreatic tuberculosis is an extremely rare disease with only 41 cases in non-immunocompromised patients reported worldwide (1966-1997). It is a curable disease and should be considered in the differential diagnosis of a pancreatic mass or abscess shown on ultrasound or computed tomography, especially in developing countries, where tuberculosis is common.

摘要

我们报告了两例经活检证实为胰腺结核的病例,患者均为非免疫功能低下者,于过去14年内在我们科室确诊并接受治疗。第一例表现为腹痛和发热,第二例表现为缺铁性贫血和严重体重减轻。两例患者的腹部超声和计算机断层扫描均提示胰腺癌。两例患者均无肺结核或肠结核。结核菌素皮肤试验呈阳性。在剖腹探查术中,胰腺的大体外观表现为无法手术切除的胰腺癌。在胰腺结核的组织学诊断明确后,两名患者均接受了为期6个月的三联抗结核治疗,并取得了成功。孤立性胰腺结核是一种极为罕见的疾病,在1966年至1997年期间,全球报道的非免疫功能低下患者仅有41例。这是一种可治愈的疾病,在超声或计算机断层扫描显示胰腺肿块或脓肿的鉴别诊断中应予以考虑,尤其是在结核病常见的发展中国家。

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