Tuberculosis of intestine

Tuberculosis of intestine

Summary

It is tubercle bacillus that infringe chronic specific infection that intestine cause, overwhelming majority continue take place to pulmonary tuberculosis, especially open pulmonary tuberculosis. Age of onset is mostly between twenty and fifty, women exceed men, about 1.85:1. Divided into ulcer type, hyperplasia type and three type phenotype pathology.


Diagnosis

Medical history and symptom:

Right lower abdomen or umbilicus week secret anguish and dull pain, bring out after taking food more, companion's not complete intestinal obstruction person, suffer from abdominal pain and present continuation, popping aggravation. The stool is used to changing, suffer from diarrhoea, the excrement and urine takes the form of pastel, very mucous, heavy after being urgent in not accompanying, it is rare to have blood in one's stool. Or suffer from diarrhoea and replace and appear with constipation. Hyperplasia type tuberculosis of intestine, many so that secret it is a main fact. Night sweat, become thin, the intersection of whole body and weak, nausea, vomit, abdominal distension, the intersection of appetite and the intersection of person who fail and symptom more with generate heat. In addition should pay attention to inquiring whether there is medical history of tuberculosis and check and treat the situation previously, whether do and resist the consumptive disease treatment, how are course of treatment and curative effect.

Experience and find:

Right lower abdomen have fixity pigeonhole sore spot, can have the intersection of gurgling sound and hyperfunction, intestines type and peristaltic wave erupt intestinal obstruction simultaneously, the hyperplasia type right lower abdomen of tuberculosis of intestine can touch the piece of the bag, generally more fixed, the medium-sized quality is hard, with the tenderness of weight. Have the intersection of anaemia and sign, check patient, have what physical sign contribute to, judge the intersection of condition and weight and pathology dividing into type of tuberculosis of intestine in detail in addition.

Auxiliary examination:

With light, intermediate anaemia more, it is generally normal that the leucocyte is counted, lymphocytes increase. There is much erythrocyte sedimentation rate to obviously increase, it is the index of judging whether tuberculosis moves about. Can see leucocyte and suppuration cell in ulcer type tuberculosis of intestine, excrement and urine, the excrement and urine concentrates and looks for the tubercle bacillus positively. See the mucous membrane increase thickly, disorderlily or destroys in X-ray examination, sick position barium pharmaceutical jumps and solicits, or the intestines wall increases thick, tubercle, out of shape. The fibrous colon mirror can find to check that promote colon, breed pathological change that the enteric and ileum has not carried, if live and examine and find the cheese granulation swollen, diagnose value importantly.

Should distinguish with cloning the disease, promoting cancer of colon, amoeba or blood fluke granulation swollenly etc..


Treat the measure

Have a rest with nutrition:

Active the intersection of tuberculosis of intestine and patient, must stay in bed, improve nutrition actively, pay intravenous high nutrition treatment if necessary, in order to strengthen resistance.

Chemical drug therapy:

Often adopt isonicotinyl hydrazine 0.3g, takes orally, once d; Rifampin 0.45g, takes orally, once d, unites chemotherapy, June - September of course of treatment. The person who has tuberculosis outside intestines on serious tuberculosis of intestine or companion, generally add and use the toxin 0.75g of the chain, IM, once d or pyrrole piperazine amide 0.5g, takes orally, 3 times d or second amine cube alcohol 0.25g, takes orally, 3 times d.

The treatment to the ill:

Use belladonna 16mg while suffering from abdominal pain, takes orally, 3 times d or 654- 2 10mg, IM. It is serious in conformity with fluid infusion to suffer from diarrhoea, it is disorderly to correct the electrolyte.

Amalgamate complete intestinal obstruction, acute punching and massive haemorrhage person, should adopt the surgical treatment in time.


Tuberculosis of intestine
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