抗結核療法初期における逆説的回盲部穿孔:まれな症例報告
Yoseph Mulatu Habte1, Binyam Mulatu Habte2, Yabetse Alemayehu Kifle1
1Ethio Tebib Hospital, Addis Ababa, Ethiopia.
International journal of surgery case reports
|January 16, 2026
まとめ
腸結核は、抗結核療法中に逆説的に穿孔を引き起こす可能性があり、まれな合併症であり、迅速な外科的介入が必要です。これらの複雑な症例でより良い結果を得るためには、早期の疑いと治療が鍵となります。
科学分野:
- 消化器病学
- 感染症
- 腫瘍外科学
背景:
- 結核(TB)は世界的な健康問題であり、肺外TBは重要です。
- 腸結核はまれですが、曖昧な胃腸症状を呈し、穿孔などの重篤な合併症を引き起こす可能性があります。
- 回盲部への関与は腸結核では一般的です。
研究 の 目的:
- 抗結核療法中の腸管穿孔の逆説的症例を報告すること。
- このまれな合併症の早期認識と管理の重要性を強調すること。
主な方法:
- 腹痛の既往歴が2年ある24歳男性の症例報告。
- 画像検査と生検を伴う大腸内視鏡検査を含む診断ワークアップ。
- 外科的介入(右半結腸切除術)と継続的な抗結核療法。
主要な成果:
- 生検で結核性腸炎を確認しました。;患者は抗結核療法開始6日後に回盲部穿孔による汎発性腹膜炎を発症しました。;外科的治療と継続的な治療により成功裏に回復しました。
結論:
- 抗結核療法中の腸管穿孔の逆説的発生は、まれではあるが重篤な合併症です。
- 菌抗原に対する遅延型過敏反応による可能性があります。
- 罹患率を減らし予後を改善するためには、迅速な外科的介入、継続的な抗結核療法、および高い臨床的疑いが不可欠です。
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