Tuberculose abdominale : étude rétrospective de 90 cas

Abdallah, M.; Larbi, T.; Hamzaoui, S.; Mezlini, E.; Harmel, A.; Ennafaa, M.; Bouslama, K.; Labben, M.; Ayari, M.; Khalfallah, N.; Najjar, Taoufik; M’rad, S.

doi:10.1016/j.revmed.2010.09.004

Cited by 11 publications

(21 citation statements)

References 34 publications

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“…Pulmonary tuberculosis is the most frequent presenting form, and intra-abdominal forms of tuberculosis are uncommon [ 24 – 26 ]. Intra-abdominal tuberculosis occurs in 3.5% of patients with extra-pulmonary tuberculosis [ 27 ], and patients with the condition can present with a myriad of non-specific symptoms so diagnosis requires a high level of suspicion [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Left-sided portal hypertension caused by peripancreatic lymph node tuberculosis misdiagnosed as pancreatic cancer: a case report and literature review

Yu¹,

Li²,

Gong

et al. 2020

BMC Gastroenterol

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Background: Left-sided portal hypertension (LSPH) is an extremely rare clinical syndrome, and it is the only form of curable portal hypertension. It is primarily caused by pancreatic disease, and is associated with complications that cause spleen vein compression. Specific symptoms are often lacking, rendering it difficult to diagnose. Splenectomy is the main treatment for cases complicated by variceal bleeding, and the effects of treatment primarily depend on the condition of the primary disease. Case presentation: The patient was a 29-year-old woman who was admitted to the hospital for repeated hematemesis and black stool. She had been misdiagnosed with pancreatic cancer 7 years prior. Combined imaging and endoscopic examination indicated varicose gastric fundus veins, a pancreatic mass, and enlarged peripancreatic lymph nodes. Laboratory investigations revealed reduced erythrocyte, platelet, and leukocyte counts, the interferon gamma release assay was positive, and liver function was normal. Abdominal exploration, splenectomy, varicose vein dissection, and lesion resection were performed via laparotomy. Postoperative biopsy analysis confirmed the diagnosis of lymph node tuberculosis. Based on the above-described factors, LSPH caused by peripancreatic lymph node tuberculosis was a diagnosed. Conclusions: Herein we describe the first reported case of LSPH caused by peripancreatic lymph node tuberculosis. When left portal hypertension occurs simultaneously, peripancreatic lymph node tuberculosis is often misdiagnosed as pancreatic cancer. Further studies are necessary to develop a more favorable diagnostic method for pancreas masses and more advantageous therapy for LSPH, especially in cases caused by mechanical compression.

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Section: Discussionmentioning

confidence: 99%

Left-sided portal hypertension caused by peripancreatic lymph node tuberculosis misdiagnosed as pancreatic cancer: a case report and literature review

Yu¹,

Li²,

Gong

et al. 2020

BMC Gastroenterol

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“…Abdominal TB represents about 6% of extra-pulmonary forms [1] . It can occur at any age with a peak frequency between 21 and 45 years of age [2] . The distribution by sex varies according to studies.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical manifestations of abdominal TB are extremely varied, which often results in a misleading picture and delayed diagnosis. Consequently, additional examinations are very important for correct diagnosis [2] .…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Syndrome as the Initial Manifestation of Retroperitoneal Tuberculosis in a Pregnant Woman

Grira

Boulvain

Janssens

2018

European Journal of Case Reports in Internal Medicine

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A 20-year-old asylum seeker presented with vomiting and left thigh pain, with a biological inflammatory syndrome. Pregnancy was diagnosed. Investigations revealed a pseudo-cystic, 20-cm-long retroperitoneal abscess, biopsy of which confirmed the diagnosis of tuberculosis. Evolution after cyst drainage and under conventional anti-tuberculosis treatment was favourable. An abdominal location of tuberculosis is rare and its diagnosis is difficult especially in countries with a low incidence of the disease. Unexplained abdominal manifestations and/or persistent biological inflammatory syndrome, especially in high-risk groups, should raise the suspicion of tuberculosis.LEARNING POINTSAbdominal tuberculosis (TB) is a challenging diagnosis especially in low-incidence countries where the disease is rarely suspected.In low-incidence countries, abdominal TB should be suspected in cases of unexplained abdominal manifestations and/or persistent inflammatory syndrome, especially in high-risk groups.The diagnosis of abdominal TB is based on a range of anamnestic and clinical symptoms and signs, imaging, culture, and invasive procedures for histology.

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“…L'intradermoréaction à la tuberculine était positive à 15 mm. Le bilan biologique objectivait un syndrome inflammatoire (CRP à 40 mg/L), une leucopénie à 3000/mm 3 tomodensitométrie thoraco-abdominopelvienne montrait une rate de taille normale avec de multiples nodules hypodenses aux différents temps d'injection, non kystiques, d'une taille moyenne de 2 mm (figure 1). Il n'existait pas d'anomalies hépatiques associées ni d'adénopathies profondes.…”

Section: Hepato-splenic Tuberculosisunclassified

“…L'atteinte hépatique est très fréquente [3], le plus souvent asymptomatique, parfois révélée par une hépatomégalie ou une cholestase biologique. Les localisations spléniques isolées sont extrêmement rares [1][2][3]. Les signes cliniques rapportés ne sont pas spéci-fiques et n'ont qu'une valeur d'orientation : amaigrissement (44,12 %) et fièvre modérée (82,3 %).…”

Section: Commentaireunclassified