消化内科ppt课件 双语肠结核与结核性腹膜炎.pptVIP

Zhirou Tan   Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University;;Intestinal tuberculosis(肠结核) is a specific chronic intestinal infection caused by mycobacterium tuberculosis(结核分枝杆菌).;Mycobacterium tuberculosis;1.Oral infection ★pulmonary tuberculosis or laryngeal（喉） tuberculosis ★drinking un-pasteurized milk ★eating with patients 2. Hematogenous disseminated: miliary （粟粒性） tuberculosis 3.Direct spread of intra-abdominal tuberculosis ;Predilection site ：ileocecal(回盲部) , ascending colon, jejunum(空肠), transverse colon, descending colon, appendix, duodenum and sigmoid colon. Pathological type Ulcer type Proliferative (增生) Mixed ; Ulcer type; Proliferative;;Complications ; ESR ↑, Hb↓ , PPD (tuberculin skin test) positive or strongly positive , T-spot;; Mucosal lesions, hyperemia, edema, ulcers ( rat-bite-like edges) or nodular masses or inflammatory polyps, bowel stenosis . Histological examination: caseous(干酪样) necrosis. Mycobacterium tuberculosis .;Ulcer;Ulcer;1. Young and middle-aged patients with parenteral tuberculosis 2. Clinical manifestations 3. Colonoscopy 4. PPD test: postive 5. Biopsy (caseating granulomas) 6. Anti-tuberculosis treatment (2 to 6 weeks) effective 7. Exploratory laparotomy (剖腹探查); Crohn’disease Colon cancer Amoebic dysentery Schistosomiasis Others: such as malignant lymphoma ;项目; Rest and nutrition ●Standard antituberculosis treatment Early, regularity, full course, appropriate amount, combination Isoniazid (异烟肼),pyrazinamide(吡嗪酰胺), rifampin (利福平) Surgical treatment: complete intestinal obstruction, acute intestinal perforation, intestinal bleeding, diagnostic difficulties ;Section 2 Tuberculous Peritonitis;It is a chronic diffuse peritoneal infection caused by mycobacterium tuberculosis;1.Etiology Mycobacterium tuberculosis 2. Infection (1) Direct spread — Mesenteric lymp