| Autor: |
Nguyen Duc Chinh, Do Duc Van, Do Son Ha, Nguyen Van Xuyen, Nguyen Quang, Ninh Viet Khai, Pham Hai Bang, Huguier, Michel |
| Zdroj: |
Thai Journal of Surgery; Jul-Sep2010, Vol. 31 Issue 3, p76-80, 5p |
| Abstrakt: |
Purpose: Gastrointestinal tuberculosis, especially complicated intestinal tuberculosis (ITB) is still an ongoing challenge for physicians and radiologists. This study aimed to assess the clinical features and related factors which might help the diagnosis and direct proper management. Materials and Methods: This was a retrospective study of all ITB diagnosed in patients over 16 years of age who were treated at Viet Duc Hospital from 2004 to 2009. ITB was confirmed by histopathological examination or PCR assay of the biopsies or surgical specimens. Results: There were 85 cases of ITB patients including 61 men and 24 women. Common symptoms were abdominal pain (90%), diarrhea (82%), weight loss (61%) and fever (55%). A medical history of TB was found in 41% of cases. The complications most commonly observed were bowel obstruction (38.8%) and peritonitis (25.5%). Ultrasound and CT scan findings were ascites, ileo-cecal bowel wall thickening, proximal dilatation of bowel loops and cecal mass. Colonoscopy with biopsy confirmed the diagnosis in 66.7% whereas PCR assay was positive in 53.9%. A pre-operative diagnosis was established in 39% of patients, while the diagnosis was established intra-operatively in 83.5%. There were surgical indications to make a diagnosis in 13.9%. Conclusion: ITB has diverse and non-specific symptoms and is an ongoing diagnostic dilemma for both physicians and radiologists. X-ray and endoscopy with biopsy are the most helpful means for establishing a definitive diagnosis. [ABSTRACT FROM AUTHOR] |
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