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腸管結核

Intestinal Tuberculosis Review of a Protean Diseas

녹십자의보 1976년 4권 3호 p.116 ~ 121
李承奎, 金鎭福,
소속 상세정보
李承奎 (  ) - 서울대학교 醫科大學 外科學敎室
金鎭福 (  ) - 서울대학교 醫科大學 外科學敎室

Abstract


In view of the variance of figures in the literature as to the clinical manifestation of the tuberculosis disease of the intestinal tract, it was thought that a survey of the material furnished by the recent six cases at the Seoul National University Hospital, might be of interest as showing its protean clinical manifestations. In the past, Crawford and Sawyer were agreed that at least seventy percents of patients with intestinal tuberculosis had associated pulmonary tuberculosis, whili in our series, there were no preexisiting pulmonary lesion in all cases, but namely in the category of primary abdominal infection. The chief complaints in individuals examined were right lower abdominal pain, generalized abdominal pain, epigastric pain and back pain, in order of decreasing frequency. Of these, one patient had no symptomatology. Physical examination revealed a mass on the right lower abdomen, signs of the peritoneal irritations, a periumbilical mass, an epigastric mass and signs of the mechanical ileus. Rediologic diagnosis was made as following variety; paralytic ileus. hollow viscus rupture, mechanical ileus, pancreatic mass and calcified coin lesion in the intraperitoneal area. Pre-operative and biopsy diagnosis were directed to the tuberculosis of the omentum, mesentery, il eocecum. Even after an enteric lesion was identified, often it was mistaken for other entities, particularly neoplasm or other intestinal inflammatory diseases. Of interest in our series, correct diagnosis was preoperatively made in only one case of six and before the final tissue diagnosis was made, we errornously thought other entities in two cases even after the operation. Obviously, the diagnosis is difficult and this report demonstrates the protean manifestations of this entity, the frequency which occurs without the pre-existing pulmonary lesion and the need for continues awareness of its high existance.

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