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versión impresa ISSN 1130-0108
Rev. esp. enferm. dig. vol.101 no.1 ene. 2009
PICTURES IN DIGESTIVE PATHOLOGY
Non-surgical acute abdomen: intestinal tuberculosis
Abdomen agudo no quirúrgico: tuberculosis intestinal
S. López García, L. Alonso Fernández, M. Alvite Canosa and C. Gómez Freijoso
Service of General Surgery A. Complejo Hospitalario Universitario. A Coruña, Spain
This was a 21-year-old woman with nonspecific findings in her clinical history, who was operated on for abdominal pain with generalized peritonism, high fever, and severe leukocytosis.
No alterations were seen in her thorax.
The following was found during the procedure: turbid ascites and generalized peritoneal seeding, particularly in the terminal ileum.
A histological examination of biopsy samples revealed tuberculoid granulomas suggestive of miliary seeding.
The patient was treated for six months with three tuberculostatic drugs (isoniazid, rifampicin, pyrazinamide), and remains asymptomatic to this day.
Diagnosis: intestinal tuberculosis.
We report a case illustrating the difficulty of diagnosing intestinal tuberculosis, especially when it affects an immunosuppressed patient without evidence of pulmonary disease. Generally speaking, the clinical presentation and complementary tests are nonspecific; in most cases, only a histopathological examination reveals the diagnosis (Figs. 1 and 2).
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