Ileocecal tuberculosis

Introduction Tuberculosis in the ileocecal area is caused by tuberculosis infection! Intestinal tuberculosis is the most common type of tuberculosis in the digestive system. The vast majority are secondary to extraintestinal tuberculosis, especially hollow tuberculosis. According to statistics, 25% to 50% of tuberculosis patients can be complicated by intestinal tuberculosis. The source of intestinal tuberculosis is mainly ingestive, caused by swallowing sputum containing tubercle bacilli, occasionally from food contaminated by tuberculosis, or directly from blood-borne or abdominal, pelvic other organs spread. The age of onset is mostly young and middle-aged, with more women than men, about 1.85:1. Pathologically divided into ulcer type, proliferative type and mixed type.

Cause

More than 90% of intestinal tuberculosis is caused by human tuberculosis. In addition, drinking dairy products that have not been strictly disinfected can cause disease due to bovine tuberculosis. Intestinal tuberculosis infection can be caused by oral, hematogenous spread and tuberculosis of adjacent organs. . The onset of tuberculosis is the result of the interaction between human body and tuberculosis. The infection obtained by the above-mentioned route is only a disease-causing condition. Only when the number of invasive tuberculosis bacteria is large, the virulence is large, and the human immune function is abnormal, and intestinal dysfunction It will only occur when the local resistance is weakened.

an examination

Related inspection

The antigen and antibody of Mycobacterium tuberculosis check the Tribrach test effusion 2-microglobulin

Confirmation of intestinal tuberculosis should confirm the presence of Mycobacterium tuberculosis in intestinal mucosa. Intestinal tuberculosis should be considered if the following conditions exist.

1. Young and middle-aged patients have extraintestinal tuberculosis, especially in patients with open tuberculosis, or the systemic manifestations of tuberculosis after the original lesion has improved.

2. Clinical manifestations include diarrhea, abdominal pain, tenderness in the right lower quadrant, abdominal block, unexplained intestinal obstruction, accompanied by fever, night sweats and other symptoms of tuberculosis.

3. X-ray barium meal examination found signs of irritability, intestinal stenosis, and shortened deformation of the intestine.

4. The tuberculin test is strongly positive. For cases with high suspicion of intestinal tuberculosis, such as anti-tuberculosis treatment for 2 to 6 weeks, a clinical diagnosis of intestinal tuberculosis can be made. If the lesion is in the terminal ileum and colon, colonoscopy and biopsy can help diagnose and differential diagnosis. For those who have difficulty in diagnosis, mainly proliferative intestinal tuberculosis, sometimes need laparotomy to confirm the diagnosis.

Differential diagnosis

Ileum repeat deformity: a type of small intestinal repeat deformity; duplication of small intestine refers to a circular or tubular structure of the hollow organ that appears on the proximal mesangial side of the small intestine, which is the same as the adjacent small intestine. The organizational structure and its blood supply are also very close. Recurrent intestinal malformations can occur in any part of the small intestine, but are most common in the ileum.

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