Abstract:
Tuberculosis (TB) is a chronic granulomatous inflammatory disease that affects any part of our body. TB is a significant problem in developing countries. Intestinal TB accounts for 2% of TB cases worldwide. Terminal ileum and cecum are the two commonly affected regions because of abundant lymphoid tissue, physiologic stasis, limited digestive activity and increased fluid and electrolyte absorption rate. Intestinal obstruction is the leading complication of intestinal TB, and it occurs because of intestinal luminal narrowing, multiple strictures or adhesions. The clinical presentation of patients with intestinal TB and post-TB intestinal obstruction is non-specific. It can be acute, chronic, or acute on chronic. Uncomplicated cases of intestinal TB can be managed medically. Surgery is reserved for complicated cases of intestinal TB, which includes peritonitis, intestinal obstruction and perforations. Here, we present a 37-year-old man who presented with long-standing, intermittent crampy abdominal pain and vomiting. He was diagnosed with chronic partial small bowel obstruction secondary to possibly small bowel carcinoma. We did segmental ileal resection and end-to-end ileo-ileal anastomosis. Postoperatively, the histopathology result turned out to be intestinal TB. This case report aims to make physicians aware of the rare condition of small bowel obstruction secondary to intestinal TB. Clinicians need to have a high index of suspicion in any patient with long-standing symptoms of partial obstruction and consider surgery and anti-TB once diagnosed.
摘要:
结核病(TB)是一种慢性肉芽肿性炎症性疾病,会影响我们身体的任何部位。结核病在发展中国家是一个重大问题。肠道TB占全球TB病例的2%。末端回肠和盲肠是两个常见的受累区域,因为淋巴组织丰富,生理停滞,有限的消化活动和增加的液体和电解质的吸收率。肠梗阻是肠结核的主要并发症,它的发生是因为肠腔狭窄,多发狭窄或粘连。肠TB和TB后肠梗阻患者的临床表现是非特异性的。它可以是急性的,慢性,或慢性急性。肠道结核的简单病例可以通过医学方式进行治疗。手术是为复杂的肠结核病例保留的,包括腹膜炎,肠梗阻和穿孔。这里,我们介绍一位37岁的男子,间歇性痉挛腹痛和呕吐。他被诊断为慢性部分小肠梗阻,可能继发于小肠癌。我们进行了节段性回肠切除和端对端回肠吻合术。术后,组织病理学结果是肠结核.此病例报告旨在使医生了解继发于肠道结核的小肠梗阻的罕见情况。临床医生需要对任何长期有部分梗阻症状的患者有很高的怀疑指数,一旦确诊就考虑手术和抗结核。