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Tuberculosis of the digestive system

Tuberculosis of the digestive systemTUBERCULOSIS OF THE DIGESTIVE SYSTEM. Tuberculosis of esophagus is one of the rare localizations of the disease and in the majority of cases occur in persons with advanced his pulmonary forms shortly before his death. Etiology, pathogenesis. Tubercle bacilli into the esophagus when swallowing infected patients with active tuberculosis of the larynx, epiglottis and pharynx, less lymphogenous or hematogenous route, as well as a direct result of the transition of tuberculosis from the surrounding bodies: bifurcation lymphatics-fir nodes, spine, thyroid, larynx, pharynx. Tubercular ulcers occur as a result of caseous collapse of tuberculosis tubercles. There are also miliary and stenoziruyuschaya forms of tuberculous lesions of the esophagus. The symptoms for. The disease may be asymptomatic, but often the symptoms are shaded more pronounced manifestations of tuberculous lesions of other organs (primarily the lungs and larynx) and severe General condition of the patient. The most striking symptom is dysphagia, which in the presence of ulcerations of mucous may be accompanied by sharp pain. X-ray examination reveals large tubercular ulcers and cicatricial narrowing of the lumen of the esophagus. Diagnosis facilitates the endoscopy, biopsy, bacteriological examination of material obtained from ulcers. Prognosis depends on the severity of tuberculous changes in the lungs and other organs. Complications: pistolese message of the esophagus with the trachea, bronchi, pleura, purulent mediastinic; breakthrough cheesy cavity in a large vessel threatens to profuse bleeding. In the healing of tuberculous ulcers are formed stricture of the esophagus, violated his cross: as a result of adhesions between the bifurcation lymph nodes and the wall of the esophagus are formed his traction diverticula. Treatment in specialized TB hospitals. When tuberculous ulcers of the esophagus inside, appoint bismuth preparations, local anesthetics. When cicatricial narrowing of the esophagus spend Bagirova; in some cases, to maintain nutritional temporarily impose a gastrostomy tube. Tuberculosis of the stomach is very rare, usually in the terminal phase of pulmonary tuberculosis. Recently, however, in patients with pulmonary tuberculosis in the long-term treatment with anti-TB drugs detected on drug gastritis". The symptoms for. The disease may be asymptomatic or accompanied by pain in the upper abdomen, belching, vomiting, sudden loss of appetite; as a rule, are of General exhaustion, fever, excessive sweating. The diagnosis of tuberculosis of the stomach is confirmed by chest x-ray and gastrofibroskopija. Therefore, special value has targeted biopsy. In the study of gastric juice is often detected ahilia, in the gastric contents (often in lavage) detect Mycobacterium tuberculosis. The course and prognosis in most cases is determined by the severity of lung and other localizations of tuberculosis. Rare complications are perforation of tuberculosis stomach ulcers, stomach bleeding, cicatricial stenosis of the pylorus. Treatment in specialized TB hospitals. Patients with tuberculous lesions of the stomach appoint sparing diet (table ? 1 a-1) and symptomatic agents (as in the treatment of gastric ulcer and duodenal ulcer). Tuberculosis of the pancreas is very rare. Even in patients with active tuberculosis of the lungs it can be detected only 0.5-2% of cases. The symptoms for. Patients complained of burps, decrease of appetite, nausea, pain in the upper left quadrant of the abdomen, often shingles character, diarrhea, increased thirst (in violation of the endocrine functions of the pancreas), progressive emaciation, increased sweating, malaise, fever. The skin sometimes gets a little darker color, as if addisonii disease. Palpation of the pancreas marked tenderness in the place of its location. Diagnosis. To confirm the diagnosis are ultrasound, retrograde retrograde cholangiopancreatography, wirsungography, scanning of the pancreas, the analysis of its external and internal secretion (characterized by failure of function). The differential diagnosis spend with nonspecific pancreatitis, malignant and benign tumors of the pancreas. The treatment is carried out in specialized TB clinics. Also nominated fractional 5-6-RA-basic diet, light diet restricted in fat, with the exception of spicy foods and high protein content. When signs of exocrine pancreatic insufficiency appoint enzyme preparations, as in chronic pancreatitis. Tuberculosis of the liver accompanied by tuberculosis of the intestine in 79-99% of cases. Tubercle bacilli enter the liver hematogenous or lymphogenesis way, it is also possible dissemination process of the bile passages. Often observed miliary form or multiple of tuberculoma liver with caseous collapse in the center. There are also non-specific changes in the liver, with tuberculosis of the lungs in the form of reactive hepatitis, fatty degeneration, the amyloidosis or hepatic (with long-term use of tuberculostatic drugs). The symptoms for. Anorexia, General malaise, weakness, increased sweating, fever, pain in the right hypochondrium. The liver is increased, the edge of her tight, in some cases, the surface is uneven (granulomatous form) or are able to probe the node on its surface (Tu-Bartolome). Often enlarged spleen. Suspect tuberculous lesions of the liver in the case of a patient with pulmonary tuberculosis revealed enlargement of the liver, marked pain in the right hypochondrium. The diagnosis is confirmed by laparoscopy, needle liver biopsy, ultrasound and scanning.


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