内科学422intestinal tuberculosis英文课件.pptxVIP

Intestinal TuberculosisIntestinal tuberculosisGeneral situationEtiology and pathogenesisPathologyClinical manifestation lab other examinationDiagnosis and differential diagnosisTreatment , prognosis and preventionGeneral ideasTuberculosis is a chronic infectious disease caused by the tubercle bacilli. Tubercle bacillus discovered in 1882.Developing countries (95%), especially poverty, malnutrition, overcrowding and HIV coinfection.Involvement of intestine is usually secondary to pulmonary tuberculosis.Gentle: male female.Age: younger. The ileocecal region is the most common area of involvement in the intestinal tract . Why ?The abundance of lymphoid tissueLong residence time of bactera in ileocucumPredisposing factorsFatiguepoor sanitationmalnutritionlowered resistance etc. Pathogenic organism----tubercle bacillustubercle bacillus maybe either the human type or bovine type human type----90% bovine type----10%Etiology and pathogenesis Route of transmissionPropagation by mouth:Hemotogenous dissemination: miliary TBSpread straightly: Etiology and pathogenesis Bacilium: number, virulenceDecreased immunity of humanWeakening of intestinal resistancePathologyulcerohypertrophichypertrophiculcerativeLocalized to ileocecal regionTuberculous granuloma Ileus (more)CaseatingTransverse ulcerStricture ileusChronic perforationAbscess, fistulaBleeding (few)Caseation Langhan’s giant cells Clinical manifestation Systemic symptoms ● Fatigue ● low-grade fever ● Night sweats ● Loss of weight ● poor appetite ● anemia Local symptoms ● abdominal distension ● ascites ● mass ● abdominal pain ● diarrhea constipation ● complicationExtraintestinal tuberculosis manifestation : pulmanory TBCachexia laboratory findingsBlood routine: Hb erythrocyte sedimentation rate, ESR ● ESR typically elevated in the active stage ● it is a useful guide to the progress of the disease , gradual decrease is the indication of healing and the effectiveness of antitubercular agents Stool routine tes