医学
肺结核
胸腔积液
外科
肺炎
脓肿
克罗恩病
组织病理学
腹痛
内科学
胃肠病学
回盲瓣
疾病
病理
回肠
作者
Andreia Guimarães,João Martins Gama,Luís Curvo‐Semedo,António Manso
出处
期刊:Case Reports
[BMJ]
日期:2023-12-01
卷期号:16 (12): e254400-e254400
标识
DOI:10.1136/bcr-2022-254400
摘要
A woman in her 20s with a recent diagnosis of Crohn’s disease (CD) affecting the ileocaecal valve was started on adalimumab, after routine tuberculosis (TB) tests were negative. Her abdominal symptoms got worse and she started presenting respiratory distress and fever. Tomography revealed a left pleural effusion, pneumonia and peritonitis with pelvic abscess. The diagnosis of disseminated TB with digestive involvement was suggested and sputum cultures were positive for Mycobacterium tuberculosis . Treatment for TB was started and immunosuppressants discontinued, leading to respiratory improvement. Abdominal imaging was repeated, showing worsening signs of multisegmental ileal wall thickening, ileocaecal valve obstruction and a persistent pelvic abscess. She was then submitted to a laparoscopic ileocaecal resection for suspicion of worsening CD. Histopathology showed chronic ileocolitis compatible with CD and ganglionic tuberculosis, revealing the diagnosis of intestinal tuberculosis superimposed in CD. Recovery was uneventful.
科研通智能强力驱动
Strongly Powered by AbleSci AI