| ObjectiveTo retrospectively analyze the history of intestinal tuberculosis patients in our hospital and to explore how to improve the clinical diagnosis of intestinal tuberculosis.MethodsThe data of 31 patients with intestinal tuberculosis who were admitted to the First Affiliated Hospital of Anhui Medical University from January 2011 to October 2016 were collected and their clinical manifestations,laboratory tests,imaging reports,pathological examination and clinical diagnosis were performed Statistical analysis.Results1.Among the 31 patients,20 were males and 11 were females,aged from 18 to 73 years,with an average of 42 years.There were 26 rural residents(83.8%),5 non-farm populations(16.2%),6 patients with definite history of tuberculosis admitted to hospital,accounting for 19.4%.2.The most common symptoms of clinical manifestations were abdominal pain(24 cases,77.4%),systemic tuberculosis poisoning in 13 cases(41.9%),right lower quadrant mass in 3 cases(9.6%),Stool changed in 10 cases(32.2%),Obstruction in 9 cases(29.0%),blood in 3 cases(9.6%),1 case of rectal mass(3.2%).3.Laboratory and imaging examination of the patients sent for different cases,summarized as follows: peripheral blood lymphocyte ratio decreased 22 cases(70.9%),ESR increased in 16 cases(84.2%),C-reactive protein(CRP)increased in 13 cases(92.8%),4 cases(66.7%)were positive for PPD test,11 cases(84.6%)were positive for T-SPOT test and 2 cases(18%)were positive for TB-Ab test,Faecal acid-fast staining test was positive in 2 cases(13.3%).4.Thoracic X-ray examination revealed 17 cases(56.7%)of pulmonary tuberculosis,of which 10 cases were old tuberculosis(58.8%),7 cases were active tuberculosis(41.2%).7 cases of active tuberculosis were corresponding to ulcer-type intestinal tuberculosis.Abdominal B-ultrasound positive findings in 7 cases,accounting for 29.6%,mainly prompted abdominal mass,ascites or regional lymph nodes,the value of diagnosis is poor.Abdominal CT scan found 13 cases of abnormalities(68.4%),of which 9 cases considered to be intestinal tuberculosis(69.2%).Positive manifestations mainly for the ileocecal stage thickening of the intestine,stenosis,with or without Lymph node enlargement or calcification.5.Combined with colonoscopy and intraoperative findings,25 lesions were located in the ileocecal region(80.6%),of which 16 were ulcer(51.6%),7 were hyperplastic(22.6%)and 8 were mixed(25.8%),From the ileocecal Department to the distal bowel,degree of lesion gradually reduced,hyperplastic type showed tumor-like changes,ulcerative lesions were often multiple,distribution along the colon bags,severe cases would lead to intestinal deformation,narrowing.6.24 patients underwent colonoscopy and pathology biopsy,6 patients found caseous necrotic granuloma,the diagnosis rate was 25%.11 cases of surgical patients were pathologically diagnosed as intestinal tuberculosis.7.6 patients underwent diagnostic antituberculosis treatment because of difficult diagnosis.After 6 to 12 weeks,the patient's condition was significantly relieved,reached the standard of clinical diagnosis.ConclusionThe clinical manifestations of patients with intestinal tuberculosis are not typical,easily confused with intestinal inflammatory diseases and tumors,colonoscopy and biopsy as the main means of detection,but the diagnosis is low,combined with T-SPOT test,chest X-ray,abdominal CT Check could improve the detection rate of the disease,if necessary,diagnostic anti-TB treatment can assist in diagnosis. |
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