AIM： To assess the clinical features, yield of the diagnostic tests and outcome of abdominal tuberculosis in non-HIV patients.METHODS： Adult patients with discharge diagnosis of abdominal tuberculosis （based upon; ...AIM： To assess the clinical features, yield of the diagnostic tests and outcome of abdominal tuberculosis in non-HIV patients.METHODS： Adult patients with discharge diagnosis of abdominal tuberculosis （based upon; positive microbiology, histo-pathology, imaging or response to trial of anti TB drugs） during the period 1999 to 2004 were analyzed. Patient＇s characteristics, laboratory investigations, radiological, endoscopic and surgical findings were evaluated. Abdominal site involved （intestinal, peritoneal, visceral, and nodal） and response to treatment was also noted.RESULTS： There were 209 patients enrolled. One hundred and twenty-three （59%） were females. Symptoms were abdominal pain 294 （93%）, fever 234 （64%）, night sweats 99 （48%）, weight loss 98 （47%）, vomiting 75 （36%）, ascites 74 （35%）, constipation 64 （31%）, and diarrhea 25 （12%）. Sub-acute and acute intestinal obstruction was seen in 28 （13%） and 12 （11%） respectively. Radiological evidence of pulmonary tuberculosis was found in 134 （64%） patients. Basis of diagnosis of abdominal tuberculosis were radiology （Chest and barium X-Rays, Ultrasound and CT scan abdomen） in 111 （53%） and histo-pathology （tissue obtained during surgery, colonoscopy, CT or ultrasound guided biopsy, laparoscopy and upper gastro intestinal endoscopy） in 87 （42%） patients. Mycobacterium culture was positive in 6/87 （7%） patients and response to therapeutic trial of anti tubercular drugs was the basis of diagnosis in 5 （2.3%） patients. Predominant site of involvement by abdominal TB was intestinal in 103 （49%） patients, peritoneal in 87 （42%） patients, solid viscera in 10 （5%） and nodal in 9 （4%） patients. Response to medical treatment was found in 158 （76%） patients and additionally 35 （17%） patients also underwent surgery. In a 425 ± 120 d follow-up period 12 patients died （eight post operative） and no case of relapse was noted.CONCLUSION： Abdominal TB has diverse and nonspecific symptomatology. No single test is adequate for diagnosis of abdominal tuberculosis in all patients. Abdominal TB in non-HIV patients remains an ongoing diagnostic dilemma requiring a high index of clinical suspicion.展开更多
18 F-fluorodeoxyglucose positron emission/computed tomography( 18 F-FDG PET/CT)imaging,an established procedure for evaluation of malignancy,shows an increased 18 F-FDG uptake in inflammatory conditions.We present thr...18 F-fluorodeoxyglucose positron emission/computed tomography( 18 F-FDG PET/CT)imaging,an established procedure for evaluation of malignancy,shows an increased 18 F-FDG uptake in inflammatory conditions.We present three patients with abdominal pain and weight loss.Conventional imaging studies indicated that abdominal neoplasm and 18 F-FDG PET/CT for assessment of malignancy showed multiple lesions with intense 18 FFDG uptake in abdomen of the three cases.However,the three patients were finally diagnosed wit...展开更多
TO THE EDITORWe read with interest the article by Uzunkoy et al[1]. about diagnosis of abdominal tuberculosis. In this article authors concluded that PCR for mycobacterium tuberculosis complex is a noninvasive method ...TO THE EDITORWe read with interest the article by Uzunkoy et al[1]. about diagnosis of abdominal tuberculosis. In this article authors concluded that PCR for mycobacterium tuberculosis complex is a noninvasive method which can provide the diagnosis in most cases. If this tests negative or not feasible, laparotomy should be performed.展开更多
BACKGROUND It is very rare to suffer from colorectal adenocarcinoma and abdominal tuberculosis simultaneously.Even in a country such as China,where tuberculosis is still endemic,its diagnosis and treatment are challen...BACKGROUND It is very rare to suffer from colorectal adenocarcinoma and abdominal tuberculosis simultaneously.Even in a country such as China,where tuberculosis is still endemic,its diagnosis and treatment are challenging.This article describes in detail a case of rectal cancer complicated by abdominal tuberculosis and its pathological features.CASE SUMMARY We outline the case of a 71-year-old female who was admitted with intermittent blood in the stool over the past year.The patient was diagnosed with low rectal cancer and received neoadjuvant therapy.The patient then returned to the hospital for surgery,but diffusely distributed nodules were found during laparoscopic exploration.The diagnosis of rectal cancer with extensive metastasis was considered during the operation.There was no opportunity for radical surgery.Thus,nodules were taken for pathological examination,and the abdomen was closed.The histopathological diagnosis was tuberculous granuloma,and the patient was treated with standardized anti-tuberculosis drugs in a specialized hospital.Later,the patient again came to our hospital and underwent abdominoperineal resection.She was discharged 10 d after the operation in good clinical condition.CONCLUSION We aim to emphasize the importance of preoperative and postoperative pathological examination in diagnosis and treatment.展开更多
Extrapulmonary Tuberculosis (EPTB) is the TB involving organs other than lungs. The diagnosis of EPTB can be difficult, as suspicion is challenging, because it presents with nonspecific clinical features and atypical ...Extrapulmonary Tuberculosis (EPTB) is the TB involving organs other than lungs. The diagnosis of EPTB can be difficult, as suspicion is challenging, because it presents with nonspecific clinical features and atypical presentation. Furthermore, patients with HIV may present with fever of unknown origin (FUO) as the only symptom. We present a clinical case of a 49 years old Puertorrican female with HIV-AIDS and no high-risk behavior with an abdominal pain and fever. The investigation confirmed an Abdominal Tuberculosis. This case emphasizes the need to add Abdominal tuberculosis (ATB) within the differential diagnosis and discuss the diagnostic process.展开更多
文摘AIM： To assess the clinical features, yield of the diagnostic tests and outcome of abdominal tuberculosis in non-HIV patients.METHODS： Adult patients with discharge diagnosis of abdominal tuberculosis （based upon; positive microbiology, histo-pathology, imaging or response to trial of anti TB drugs） during the period 1999 to 2004 were analyzed. Patient＇s characteristics, laboratory investigations, radiological, endoscopic and surgical findings were evaluated. Abdominal site involved （intestinal, peritoneal, visceral, and nodal） and response to treatment was also noted.RESULTS： There were 209 patients enrolled. One hundred and twenty-three （59%） were females. Symptoms were abdominal pain 294 （93%）, fever 234 （64%）, night sweats 99 （48%）, weight loss 98 （47%）, vomiting 75 （36%）, ascites 74 （35%）, constipation 64 （31%）, and diarrhea 25 （12%）. Sub-acute and acute intestinal obstruction was seen in 28 （13%） and 12 （11%） respectively. Radiological evidence of pulmonary tuberculosis was found in 134 （64%） patients. Basis of diagnosis of abdominal tuberculosis were radiology （Chest and barium X-Rays, Ultrasound and CT scan abdomen） in 111 （53%） and histo-pathology （tissue obtained during surgery, colonoscopy, CT or ultrasound guided biopsy, laparoscopy and upper gastro intestinal endoscopy） in 87 （42%） patients. Mycobacterium culture was positive in 6/87 （7%） patients and response to therapeutic trial of anti tubercular drugs was the basis of diagnosis in 5 （2.3%） patients. Predominant site of involvement by abdominal TB was intestinal in 103 （49%） patients, peritoneal in 87 （42%） patients, solid viscera in 10 （5%） and nodal in 9 （4%） patients. Response to medical treatment was found in 158 （76%） patients and additionally 35 （17%） patients also underwent surgery. In a 425 ± 120 d follow-up period 12 patients died （eight post operative） and no case of relapse was noted.CONCLUSION： Abdominal TB has diverse and nonspecific symptomatology. No single test is adequate for diagnosis of abdominal tuberculosis in all patients. Abdominal TB in non-HIV patients remains an ongoing diagnostic dilemma requiring a high index of clinical suspicion.
文摘18 F-fluorodeoxyglucose positron emission/computed tomography( 18 F-FDG PET/CT)imaging,an established procedure for evaluation of malignancy,shows an increased 18 F-FDG uptake in inflammatory conditions.We present three patients with abdominal pain and weight loss.Conventional imaging studies indicated that abdominal neoplasm and 18 F-FDG PET/CT for assessment of malignancy showed multiple lesions with intense 18 FFDG uptake in abdomen of the three cases.However,the three patients were finally diagnosed wit...
文摘TO THE EDITORWe read with interest the article by Uzunkoy et al[1]. about diagnosis of abdominal tuberculosis. In this article authors concluded that PCR for mycobacterium tuberculosis complex is a noninvasive method which can provide the diagnosis in most cases. If this tests negative or not feasible, laparotomy should be performed.
文摘BACKGROUND It is very rare to suffer from colorectal adenocarcinoma and abdominal tuberculosis simultaneously.Even in a country such as China,where tuberculosis is still endemic,its diagnosis and treatment are challenging.This article describes in detail a case of rectal cancer complicated by abdominal tuberculosis and its pathological features.CASE SUMMARY We outline the case of a 71-year-old female who was admitted with intermittent blood in the stool over the past year.The patient was diagnosed with low rectal cancer and received neoadjuvant therapy.The patient then returned to the hospital for surgery,but diffusely distributed nodules were found during laparoscopic exploration.The diagnosis of rectal cancer with extensive metastasis was considered during the operation.There was no opportunity for radical surgery.Thus,nodules were taken for pathological examination,and the abdomen was closed.The histopathological diagnosis was tuberculous granuloma,and the patient was treated with standardized anti-tuberculosis drugs in a specialized hospital.Later,the patient again came to our hospital and underwent abdominoperineal resection.She was discharged 10 d after the operation in good clinical condition.CONCLUSION We aim to emphasize the importance of preoperative and postoperative pathological examination in diagnosis and treatment.
文摘Extrapulmonary Tuberculosis (EPTB) is the TB involving organs other than lungs. The diagnosis of EPTB can be difficult, as suspicion is challenging, because it presents with nonspecific clinical features and atypical presentation. Furthermore, patients with HIV may present with fever of unknown origin (FUO) as the only symptom. We present a clinical case of a 49 years old Puertorrican female with HIV-AIDS and no high-risk behavior with an abdominal pain and fever. The investigation confirmed an Abdominal Tuberculosis. This case emphasizes the need to add Abdominal tuberculosis (ATB) within the differential diagnosis and discuss the diagnostic process.
