PDF(Pubmed)
Abstract：
The complication of hydropneumothorax and colovesical fistula is rare, especially in patients with tuberculosis (TB) and COVID-19. This particular situation poses a management difficulty, and can significantly threaten the patient\'s life without a clear diagnosis and timely treatment. We report a 28-year-old woman with pulmonary and intestinal TB with COVID-19 complicated with hydropneumothorax and colovesical fistula (CVF) which worsened her condition. Treatment for this patient was given according to the diagnosis. Her condition improved and she was discharged after 30 days of hospitalization, while elective surgery for CVF was not performed because there were no clinical symptoms complained of by this patient after completing TB treatment (9 months after hospital discharge). This case report highlights the importance of considering pulmonary and intestinal TB with COVID-19 as the cause of hydropneumothorax and CVF. Early and complex diagnosis is essential for proper management, as well as the efficacy of medical therapy and treatment for controlling such advanced stages of the disease. A complex condition with many symptoms can overlap with other diseases. Clinicians should consider the clinical symptoms, radiological imaging, and standard or supporting examination for accurate diagnosis to find the etiology of the diseases. Complete treatment for TB should be considered as the treatment choice (nonsurgical therapy) for CVF caused by TB before deciding on surgical intervention.
摘要：
水气胸和结肠膀胱瘘的并发症很少见，特别是在结核病（TB）和COVID-19患者中。这种特殊情况给管理带来了困难，如果没有明确的诊断和及时的治疗，就会严重威胁患者的生命。我们报告了一名28岁的患有肺和肠结核的女性，患有COVID-19并伴有水气胸和结肠膀胱瘘（CVF），这使她的病情恶化。根据诊断给予治疗。病情好转,住院30天后出院,而未进行CVF择期手术,因为该患者在完成TB治疗后(出院后9个月)没有主诉临床症状.本病例报告强调了考虑以COVID-19为原因的肺部和肠道结核的重要性。早期和复杂的诊断对于正确的管理至关重要，以及控制这种疾病晚期的药物治疗和治疗的功效。具有许多症状的复杂状况可以与其他疾病重叠。临床医生应考虑临床症状，放射成像，和标准或辅助检查，以准确诊断，以找到疾病的病因。在决定手术干预之前，应考虑将结核病的完全治疗作为结核病引起的CVF的治疗选择（非手术治疗）。
