• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>World Journal of Gastroenterology >A clinical dilemma: abdominal tuberculosis
【24h】

A clinical dilemma: abdominal tuberculosis

机译：临床难题：腹部结​​核

获取原文
获取原文并翻译 | 示例
       
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

AIM: To evaluate the clinical, radiological and microbiological properties of abdominal tuberculosis (TB) and to discuss methods needed to get the diagnosis. METHODS: Thirty-one patients diagnosed as abdominal TB between March 1998 and December 2001 at the Gastroenterology Department of Kartal State Hospital, Istanbul, Turkey were evaluated prospectively. Complete physical examination, medical and family history, blood count erythrocyte sedimentation rate, routine biochemical tests, Mantoux skin test, chest X-ray and abdominal ultrasonography (USG) were performed in all cases, whereas microbiological examination of ascites, upper gastrointestinal endoscopy, colonoscopy or barium enema, abdominal tomography, mediastinoscopy, laparoscopy or laparotomy were done when needed. RESULTS: The median age of patients (14 females, 17 males) was 34.2 years (range 15-65 years). The most frequent symptoms were abdominal pain and weight loss. Eleven patients had active pulmonary TB. The most common abdominal USG findings were ascites and hepatomegaly. Ascitic fluid analysis performed in 13 patients was found to be exudative and acid resistant bacilli were present in smear and cultured only in one patient with BacTec (3.2 %). Upper gastrointestinal endoscopy yielded nonspecific findings in 16 patients. Colonoscopy performed in 20 patients showed ulcers in 9 (45 %), nodules in 2 (10 %) and, stricture, polypoid lesions, granulomatous findings in terminal ileum and rectal fistula each in one patient (5 %). Laparoscopy on 4 patients showed dilated bowel loops, thickening in the mesentery, multiple ulcers and tubercles on the peritoneum. Patients with abdominal TB were divided into three groups according to the type of involvement. Fifteen patients (48 %) had intestinal TB, 11 patients (35.2 %) had tuberculous peritonitis and 5 (16.8 %) tuberculous lymphadenitis. The diagnosis of abdominal TB was confirmed microbiologically in 5 (16 %) and histo-pathologically in 19 patients (60.8 %). The remaining nine patients (28.8 %) had been diagnosed by a positive response to antituberculous treatment. CONCLUSION: Neither clinical signs, laboratory, radiological and endoscopic methods nor bacteriological and histopathological findings provide a gold standard by themselves in the diagnosis of abdominal TB. However, an algorithm of these diagnostic methods leads to considerably higher precision in the diagnosis of this insidious disease which primarily necessitate a clinical awareness of this serious health problem.
机译：目的：评估腹部结核（TB）的临床，放射学和微生物学特征，并讨论获得诊断所需的方法。方法：对1998年3月至2001年12月在土耳其伊斯坦布尔的卡尔塔尔州立医院消化内科诊断为腹部结核的31例患者进行了前瞻性评估。所有病例均进行了全面的体格检查，病史和家族史，血细胞计数，红细胞沉降率，常规生化检查，Mantoux皮肤检查，胸部X线检查和腹部超声检查（USG），而腹水的微生物学检查，上消化道内窥镜检查，结肠镜检查或钡灌肠，腹部断层扫描，纵隔镜检查，腹腔镜检查或剖腹手术在需要时进行。结果：患者的平均年龄（14名女性，17名男性）为34.2岁（范围15-65岁）。最常见的症状是腹痛和体重减轻。 11例患者患有活动性肺结核。腹部USG最常见的发现是腹水和肝肿大。发现13例患者的腹水分析是渗出性的，涂片中存在抗酸杆菌，仅一名BacTec患者（3.2％）对其进行了培养。上消化道内窥镜检查在16例患者中产生非特异性发现。在20例患者中进行的结肠镜检查显示溃疡9例（45％），结节2例（10％），狭窄，多发性息肉病灶，末端回肠和直肠瘘肉芽肿发现均在1例患者中（5％）。 4例患者的腹腔镜检查显示肠管扩张，肠系膜增厚，腹膜多处溃疡和结节。腹部结核患者根据受累类型分为三组。 15例（48％）患有肠结核，11例（35.2％）患有结核性腹膜炎，5例（16.8％）患有结核性淋巴结炎。在微生物学上证实腹部结核的诊断为5例（16％），在组织病理学上证实为19例（60.8％）。其余9名患者（28.8％）已通过抗结核治疗的阳性反应被诊断出。结论：无论是临床体征，实验室检查，放射学和内窥镜检查方法，还是细菌学和组织病理学检查，都不是诊断腹部结核的黄金标准。然而，这些诊断方法的算法导致该隐性疾病的诊断具有相当高的精确度，这首先需要对该严重健康问题的临床认识。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号