胰头部结核八例报告

Tuberculosisofthepancreatichead

作者回顾了８例胰头部结核的诊治经验与教训。本组患者男女各４例，平均年龄４２．８岁。８例患者皆有程度不等的结核中毒症状和右上腹痛。其中４例右上腹扪及包块，３例有黄疸，４例脾大和脾亢。６例患者血沉增快。４例患者中３例结核菌素试验呈阳性反应。钡餐造影显示十二指肠弯变形，十二指肠溃疡、粘膜破坏或狭窄。Ｂ超和ＣＴ显示胰腺有密度不均的肿块或囊实性占位。ＥＲＣＰ显示胆管和胰管走向异常或受压。本组病例术前考虑到胰腺或腹腔淋巴结核者５例。８例患者接受剖腹手术，术中胰头部包块活检均经病理学检查证实为结核。有结核脓肿形成者行引流手术。术后抗痨治疗。所有患者预后良好。

Eightpatientswithtuberculosisoftheheadofthepancreaswereretrospectivelyre-viewed.Theywere4menand4women(meanage42.8years).Alpatientscomplainedoffever,sweat-ing,fatigue,weightloss,andinthepainintheupperrightbely.Abdominalmasswasnotedin4pa-tients,jaundicein3,andsplenomegalywithhypersplenismin4.Amongthe8patients,5suferedtuber-culosisofthepancreasbeforetheoperation.Alofthemreceivedlaparotomy.Pancreatictuberculosisinthealpatientswasconfirmedbypathologicaly.Tuberculosisabscesswasdrainedoperatively.Antitu-berculosistherapywasavailableforalpatientsaftertheoperation.