PDF(Pubmed)
Abstract：
In this editorial, we comment on the article by Ali et al published in the recent issue of the World Journal of Clinical Cases. This case report shed light on a particularly rare manifestation of this disease-primary gastrointestinal tuberculosis (GTB) presenting as gastric outlet obstruction. GTB presents diagnostic challenges due to its nonspecific symptoms and lack of highly accurate diagnostic algorithms. This editorial synthesizes epidemiological data, risk factors, pathogenesis, clinical presentations, diagnostic methods, and therapies to raise awareness about GTB. GTB constitutes 1%-3% of all tuberculosis cases globally, with 6%-38% of patients also having pulmonary tuberculosis. Pathogenesis involves various modes of Mycobacterium tuberculosis complex entry into the gastrointestinal system, with the terminal ileum and ileocecal valve commonly affected. Clinical presentation varies, often resembling other intra-abdominal pathologies, necessitating a high index of suspicion. Diagnostic tools include a combination of biochemical, microbiological, radiological, and endoscopic assessments. Anti-tubercular medication remains the cornerstone of treatment, supplemented by surgical intervention in severe cases. Multidisciplinary management involving gastroenterologists, surgeons, pulmonologists, and infectious disease specialists is crucial for optimal outcomes. Despite advancements, timely diagnosis and management challenges persist, underscoring the need for continued research and collaboration in addressing primary GTB.
摘要：
在这篇社论中，我们对Ali等人发表在最近一期的《世界临床病例杂志》上的文章进行了评论。此病例报告揭示了这种疾病的一种特别罕见的表现-原发性胃肠道结核（GTB），表现为胃出口梗阻。GTB由于其非特异性症状和缺乏高度准确的诊断算法而提出了诊断挑战。这篇社论综合了流行病学数据，危险因素，发病机制，临床表现,诊断方法,以及提高对GTB认识的治疗方法。GTB占全球所有结核病病例的1%-3%，6％-38％的患者也患有肺结核。发病机制涉及结核分枝杆菌复合体进入胃肠道系统的各种模式，末端回肠和回盲瓣常受累。临床表现各不相同，通常类似于其他腹内病变，需要高度怀疑。诊断工具包括生化，微生物,放射学,和内窥镜评估。抗结核药物仍然是治疗的基石，在严重病例中辅以手术干预。涉及胃肠病学家的多学科管理，外科医生,肺病学家,传染病专家对于最佳结果至关重要。尽管取得了进步，及时诊断和管理挑战依然存在，强调在解决原发性GTB方面需要继续研究和合作。
