PDF(Pubmed)
Abstract：
The incidence of tuberculosis (TB) worldwide is still significantly high, with India contributing a high global TB burden. This case study features a 49-year-old male who had complaints of pain and abdominal distention for one and a half months. An erect abdominal radiograph showed features suggesting small bowel obstruction. Contrast-enhanced computed tomography (CT) of the abdomen was done. It showed multiple strictures involving the distal jejunum and ileum, causing small bowel obstruction. There was mesenteric and retroperitoneal lymphadenopathy with central necrosis and ascites. The patient was operated on for a small bowel obstruction. The resected intestine showed four strictures, tiny nodules on the serosal surface, and many enlarged lymph nodes. Representative tissue from these areas showed the typical picture of multiple caseating granulomas and fibrosis. Ziehl-Neelsen (ZN) staining highlighted the acid-fast bacilli (AFB). The suspicion index for intestinal tuberculosis (ITB) should be kept high while evaluating patients with intestinal obstruction presenting in endemic areas and high-risk populations, such as HIV-infected, undernourished, immunocompromised, and those with diabetes, smoking, and alcohol addiction.
摘要：
全球范围内的结核病(TB)发病率仍然很高,印度造成了全球结核病负担。该案例研究以一名49岁的男性为特征，该男性患有疼痛和腹胀一个月。直立腹部X光片显示提示小肠梗阻的特征。进行了腹部对比增强计算机断层扫描（CT）。它显示了多个狭窄，涉及远端空肠和回肠，导致小肠梗阻.肠系膜和腹膜后淋巴结肿大伴中央坏死和腹水。该患者因小肠梗阻而接受手术。切除的肠显示四个狭窄，浆膜表面的微小结节，和许多肿大的淋巴结。来自这些区域的代表性组织显示出多发性干酪样肉芽肿和纤维化的典型图像。Ziehl-Neelsen(ZN)染色突出显示了抗酸杆菌(AFB)。在评估流行区和高危人群中出现肠梗阻的患者时，应保持肠结核（ITB）的怀疑指数较高，如艾滋病毒感染，营养不良,免疫受损，那些患有糖尿病的人，吸烟,酒精成瘾。
