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題名 | Colon and Rectal Tuberculosis: 21 Cases Experience=大腸與直腸結核病:21例報告 |
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作者 | 柯勳廷; 柯柏昇; 顏志軒; 黃德修; Ker, Shiun Tim; Ker, Robert Sam; Yen, Tsu San; Huang, Te Sho; Naritoku,Wesley Yo; Corman,Marvin Lewis; Beart,Robert William; |
期刊 | 中華民國外科醫學會雜誌 |
出版日期 | 20000100、20000200 |
卷期 | 33:1 民89.01-02 |
頁次 | 頁21-25 |
分類號 | 416.245 |
語文 | eng |
關鍵詞 | 大腸與直腸結核病; Tuberculosis; Colon and rectum; Myco-bacteria; Granuloma; |
中文摘要 | 雖然結核病在美國有上升的趨勢,可是大腸及結核病仍然少見,這種病的診斷往往被延誤,有時很困難診斷,因此本報告目的在於希望確認大腸及直腸結核病臨床特徵及早期診斷的可能性。我們研究從1985到1997年南加州大學醫院14個病例及台北醫學院7個病例,結果發現最常見的症狀是腹痛(52.4%),其次為體重減輕(28.6%) ,或下腸胃道出血,發燒畏寒,有一個病人有腸阻塞,另一個病人腸穿孔。十個病人有肺結核,不過其中只有六個是開放性結核病。五個病人有陽性PPD反應,四個病人有陽性HIV反應。十二個病人接受大腸鏡檢查;其中八人在盲腸有腫瘤,兩人有大腸潰瘡,一人有大腸發炎,一人有不規則腸狹窄。在十四人接受各種不同手術,其中三人死亡(21.4%),七人不需要手術,其中一人死亡(14.3%),整體死亡率為19.0%。我們發現大腸及直腸結核病是一種罕見的疾病,死亡率很高。高度警覺性及早期診斷是成功治療的要件。 |
英文摘要 | Although the incidence of tuberculosis in the United States is rising, colon and rectal tuberculosis is still rather uncommon. The diagnosis is often delayed and sometimes difficult. To ascertain the clinical characteristics of colon and rectal tuberculosis and the possibility of early diagnosis and treatment. The records of fourteen cases of colon and rectal tuberculosis at the University of Southern California and seven cases at Taipei Medical College from 1985 to 1997 were retrospectively reviewed. The most common symptom was abdominal pain (52.4%), followed by weight loss (28.6%), lower gastrointestinal bleeding, fever and chills. One patient presented with bowel obstruction. One patient had perforations of small bowel. Ten patients had pulmonary tuberculosis; however, only six patients had active pulmonary TB. PPD was positive in five patients. HIV was positive in four patients. Twelve patients underwent colonoscopies; eight patients had masses in the cecal area; two patients had ulcerations; one patient had inflammation; and one patient had irregular narrowing. Fourteen patients underwent various surgeries. Of these fourteen patients, three patients died (21.4%). Seven patients did not undergo surgery. Of these, one patient died (14.3%). The overall mortality was 19.0% in this group. Colon and rectal tuberculosis is an uncommon disease which carries high mortality. High index of suspicion and early diagnosis are the keys to successful treatment. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。