Pathophysiology
doi: 10.25005/2074-0581-2019-21-1-95-100
IMPROVEMENT RESULTS OF DIAGNOSIS AND TREATMENT OF ABDOMINAL TUBERCULOSIS
1Department of Surgical Diseases № 1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2Istiklol Medical Complex, Dushanbe, Republic of Tajikistan
Objective: To improve the results of diagnosis and surgical treatment of abdominal tuberculosis (AT)
Methods: The results of the diagnosis and treatment of 56 patients with AT were studied. Clinical, laboratory and instrumental methods of investigation, including ultrasound (US) and computed tomography (CT) were used. In 49 cases video laparoscopy was made, both in terms of diagnosis and treatment
Results: With US of the abdominal cavity in patients with AT, there has been a specific ultrasound semiotics with the form of having a free fluid, moderate inflating the intestinal loops and reducing peristalsis. Thickening and knotty of the parietal and, in places, the visceral peritoneum were additional signs of AT. Radiographically, in 17 (30.3%) patients, local spasm, spastic filling defect, delay of barium suspension in the iliac either caecum «reared» loops of small intestine and segmental expansion of intestinal loops. 21 observations of CT showed itself as the most effective imaging method. Tuberculosis of the liver and spleen (n=5) with CT has manifested itself in the form of tiny low-density foci distributed throughout the body. Video laparoscopy in 34 (69.4%) cases revealed hypertrophic form of AT, in 10 (20.4%) – ulcerative-hypertrophic and in 5 (10.2%) observations – ulcerative form of AT. After taking a biopsy and fluid, aeration and irradiation of the abdominal cavity was carried out with ultraviolet rays. In 2 (4.1%) cases, the conversion was completed. In the postoperative period, all patients received symptomatic therapy. No early ostoperative complications were noted
Conclusion: Both US and CT were the most effective in terms of non-invasive diagnosis. Videolaparoscopy along with an important diagnostic value in some cases can be effectively used as a therapeutic method.
Keywords: Abdominal tuberculosis, diagnosis, surgical treatment, computed tomography, video laparoscopy.
References
- Kulchavenya EV. Kontrol’ vnelyogochnogo tuberkulyoza v Sibiri i na Dal’nem Vostoke [Extrapulmonary tuberculosis control in Siberia and Far East]. Problemy tuberkulyoza i bolezney lyogkikh. 2008;9:16-9.
- Aryamkina OL, Savonenkova LN. Abdominal’nyy tuberkulyoz [Abdominal tuberculosis]. Gastroenterologiya Sankt-Peterburga. 2008;1:41-3.
- Chikaev VF, Bondaryov YuV, Ziyatdinov KM, Petukhov DM. Osobennosti diagnostiki i lecheniya tuberkulyoznogo peritonita [Diagnosis and treatment of tuberculous peritonitis]. Prakticheskaya meditsina. 2014;4(2):156-9.
- Bobokhojaev OI, Sirodjidinova UYu, Djumaev RR, Makhmudzoda IS. K voprosy o reaktivatsii tuberkulyoznogo protsessa [To the issue of the reactivation of the tuberculosis process]. Vestnik Avitsenny [Avicenna Bulletin]. 2018;20(2- 3):320-4. Available from: http://dx.doi.org/10.25005/2074-0581- 2018-20- 2-3-320-324.
- Ergeshov AE, Punga VV, Rusakova LI, Sterlikov SA, Yakimova MA, Izmaylova TV. Tuberkulyoz s mnozhestvennoy i shirokoy lekarstvennoy ustoychivost’yu mikobakteriy tuberkulyoza v Rossiyskoy Federatsii [Tuberculosis with multidrug-resistant and extensively drug-resistant of Micobacterium tuberculosis in the Russian Federation]. Vestnik Avitsenny [Avicenna Bulletin]. 2018;20(2-3):314-9. Available from: http://dx.doi. org/10.25005/2074-0581-2018-20-2-3-314-319.
- Nechaeva OB. Epidemicheskiy protsess pri tuberkulyoze v sochetanii s VICH infektsiey v Rossiyskoy Federatsii. Prognoz razvitiya [The epidemic process in the presence of tuberculosis associated with HIV-infection in the Russian Federation. Development prognosis]. TB/VICH v Rossiyskoy Federatsii. Epidemiologiya, osobennosti klinicheskikh proyavleniy i rezul’taty lecheniya. Moscow, RF: RIO TSNIIOIZ; 2017. p. 7-16
- Khakimov MA, Tillashaykhov PL. Laparoskopiya pri tuberkulyoze organov bryushnoy polosti. Tuberkulyoz i bolezni lyogkikh. 2015;6:166-7.
- Smith BM, Schwartzman K, Bartlett G, Menzies D. Adverse events associated with treatment of latent tuberculosis in the general population. Can Med Ass Journ. 2011;183(3):173-9.
- Smotrin SM, Gavrilik BL. Khirurgicheskie oslozhneniya abdominal’nogo tuberkulyoza [Surgical complications of abdominal tuberculosis]. Zhurnal Grodnenskogo gosudarstvennogo meditsinskogo universiteta. 2011;3:69-70.
- Beloborodov VA, Frolov AP. Abdominal’nyy tuberkulyoz v urgentnoy khirurgii [Abdominal tuberculosis in emergency surgery]. Sibirskiy meditsinskiy zhurnal. 2016;2:79-82.
- Mukanbaev KM, Abdiev MD, Kozhomkulov DK, Kudayberdiev TKh, Kozhomkulov MD, Dudenko EV. Osobennosti tsitokinovogo balansa pri vnelyogochnykh formakh tuberkulyoza do i v protsesse lecheniya [Features of the cytokine balance in extrapulmonary tuberculosis before and during the treatment]. Vestnik Avitsenny [Avicenna Bulletin]. 2018;20(2-3):254-60. Available from: http://dx.doi.org/10.25005/2074-0581-2018-20-2-3-254-260.
- Makhmadov FI, Asoev MS. Kompleksnaya diagnostika abdominal’nogo tuberkulyoza [Complex diagnosis of abdominal tuberculosis]. Al’manakh instituta khirurgii im. A.V. Vishnevskogo. 2017;2:508-9.
- Skopin MS, Kornilova Zkh, Batyrov FA, Matrosov MV. Osobennosti klinicheskoy kartiny i diagnostiki oslozhnyonnykh form tuberkulyoza organov bryushnoy polosti [Features of the clinical picture and diagnosis of complicated forms of tuberculosis of the abdominal cavity]. Problemy tuberkulyoza i bolezney lyogkikh. 2008;9:32-40
- Beloborodov VA, Frolov AP, Tsoktoev DB, Oleynikov IYu. Klinika, diagnostika i lechenie abdominal’nogo tuberkulyoza v urgentnoy khirurgii [Clinical picture, diagnostics and treatment of abdominal tuberculosis in urgent surgery]. Acta Biomedica Scientifica. 2017;2(6):82-5.
- Sanginov AB, Sharipov FR, Rozikov ShI, Khasanov AD, Saidov KhV. Khirurgicheskie metody lecheniya lyogochnykh i vnelyogochnykh form tuberkulyoza [Surgical treatment of pulmonary and extrapulmonary tuberculosis]. Vestnik Avitsenny [Avicenna Bulletin]. 2018;20(2-3):276-80. Available from: http://dx.doi.org/10.25005/2074-0581-2018-20-2-3-276-280.
Author information:
Makhmadov Farukh Isroilovich
of Medical Sciences, Professor of the Department of Surgical Diseases № 1, Avicenna Tajik State Medical University; First Deputy Director of the Istiklol Medical Complex
Asoev Mukhridin Sadurdinovich
Competitor at the Department of Surgical Diseases № 1, Avicenna Tajik State Medical University
Information about support in the form of grants, equipment, medications
The work was carried out according to the plan of scientific research works of the Avicenna Tajik State Medical University (state registration number – 00023576). The authors did not receive financial support from manufacturers of medicines and medical equipment.
Conflicts of interest: No conflict
Address for correspondence:
Makhmadov Farukh Isroilovich
Doctor of Medical Sciences, Professor of the Department of Surgical Diseases № 1, Avicenna Tajik State Medical University
734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139
Tel.: +992 (900) 754490
E-mail: fmahmadov@mail.ru
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