雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

A Case of Intestinal Tuberculosis S. Nakazawa 1 , K. Segawa 1 , K. Imai 1 , T. Kachi 1 , S. Hayashi 1 , T. Hattori 2 , H. Ishigure 2 1Second Department of Internal Medicine, Nagoya University School of Medicine 2First Department of Surgery, Nagoya University School of Medicine pp.1675-1680
Published Date 1977/12/25
DOI https://doi.org/10.11477/mf.1403112442
  • Abstract
  • Look Inside

 A 51 years old man was admitted to our hospital, complaining of diarrhea for two years. His past history showed swelling of hilar lymph node 37 years ago, rheumatic arthritis from 10 years ago and anal prolapsus six years ago.

 He had anemia and hypoproteinemia. Stool examinations for occult blood were strongly positive. Cultures of stool and biopsy specimen were negative for tubercle bacillus.

 Roentgenographic examination: Barium filled picture revealed marked shortening and stricture of the bowel and associated rectal stenosis. Double contrast picture showed ulcerative change with rough mucosal surface and mucosal convergence.

 Endoscopic examination: An irregular-shaped ulcer and pseudopolyposis were seen of the descending colon. Stenosis of the rectum with bleeding was observed at a point 4 cm from anus. Biopsy showed only non-specific inflammation.

 Pathological fingings: Subtotal colectomy was performed. Grossly resected specimen showed strong stricture whose wall was hypertrophic. Multiple ulcers and pseudopolyposis resembled cobblestone appearance. Rectal mucosa was normal, but there were ulcerations near the anal edge. Microscopically shallow ulcers spread broadly. Intestinal wall of the lesion was thickened by inflammatory granuloma and infiltrated by numerous lymphocytes and plasma cells.

 Some epitheloid cell granuloma were observed, and on the other side tuberculous glanuloma with a tendency to caseation necrosis was observed. Characteristic tuberculous granuloma was observed in the lymph node.

 This case was difficult to be differentiated from Crohn's disease, because it showed stricture, cobblestone-like finding and epitheloid cell granuloma. But the diagnosis was determined by detailed microscopic examination.


Copyright © 1977, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

関連文献

もっと見る

文献を共有