腹壁結核の1例 [in Japanese] A PATIENT WITH ABDOMINAL TUBERCULOSIS [in Japanese]
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A 62-year-old woman visited our department with a swelling 4cm in diameter that she had begunto feel in the midline of her abdomen, about 3 fingerbreadths below the umbilicus, since March 2001. Chest radiography revealed disseminated miliary shadows in the left lung. Abdominal computed tomography (CT) disclosed an encapsulated mass in the rectus abdominis muscle and calcification of the mesenteric lymph nodes. Gastrointestinal contrast-radiographic findings were normal. With the diagnosis of abdominal abscess made based on the above findings, a skin incision was made immediately over the swelling. Thick viscous white pus squirted out. An incision was then made over the abscess, and open drainage was performed. A small exploratory laparotomy performed for examining intestinal communication revealed significant intraabdominal adhesions and numerous white granular tubercles on the serosal surface of the intestine. Histopathology showed inflammatory granulation tissue with caseous necrosis, and epithelioid granulation tissue on the wall of the abscess. The presence of Mycobacterium tuberculosis in the pus was confirmed by the polymerase chain reaction (PCR) method. A diagnosis of abdominal tuberculosis was thus made. Antituberculous chemotherapy was initiated postoperatively. Besides this patient, only 10 patients with confirmed abdominal tuberculosis have been reported in Japan since 1987. We present here our patient with abdominal tuberculosis, with a review of some relevant literature.
- Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 63(5), 1288-1291, 2002-05-25
Japan Surgical Association