临床误诊误治2016，Vol.29Issue(11)：12-15,4.DOI:10.3969/j.issn.1002-3429.2016.11.005
食管结核误诊分析并文献复习
Misdiagnosis Analysis and Literature Review for Esophageal Tuberculosis
靳大川 1姬广森 2杨亚琦 1袁晓燕 1武淑芳1
作者信息
- 1. 450015 郑州,郑州市第六人民医院国际医疗部
- 2. 450015 郑州,郑州市第六人民医院肝病二科
- 折叠
摘要
Abstract
Objective To investigate pathogenesis, clinical features, key points of diagnosis and treatment, misdiag-nosed reasons and prevention methods for esophageal tuberculosis. Methods Clinical data of one patient misdiagnosed as having esophageal tuberculosis in recent years was retrospectively analyzed, and related literature was also reviewed. Results The patient visited the doctor for odynophagia for 2 months, aggravated condition associated by afternoon low-grade fever and night sweats for 10 days. Coronary heart disease was suspected when the patient had visited a local hospital, but no abnormal condition was found by electrocardiogram ( ECG) examination. Afterwards, esophageal ulcer was diagnosed in a provincial hospital after gastroscope and biopsy, and esophageal tuberculosis could not be excluded. After pathology consultation by an-other provincial hospital, granulomatous inflammation caused by cat-scratch disease could not be excluded. One month ago, the patient visited our hospital and was diagnosed as having reflux esophagitis and esophageal ulcer after related medical exami-nations. The symptoms aggravated after corresponding treatment, and the patient visited our hospital again for afternoon lower-grade fever and night sweats for 10 days. Esophageal tuberculosis was highly suspected after comprehensive evaluation. The symptoms were obviously alleviated, and the patient was discharged after experimental anti-tuberculosis four-drugs treatment for 4 weeks. Two-drugs anti-tuberculosis treatment for 7 months was performed after four-drugs anti-tuberculosis treatment for 1 month was completed after discharging. Endoscopy rechecking after ending 6 months of anti-tuberculosis treatment showed that only scarring was found without the ulcer. Conclusion Esophageal tuberculosis is rare with nonspecific clinic manifestation, and therefore it is easily misdiagnosed. So clinicians should collect patients' medical history in great detail, learn clinical char-acteristics and proper way of diagnosis and treatment to avoid misdiagnosis and mistreatment.关键词
结核,食管/误诊/冠心病/食管溃疡Key words
Tuberculosis/Esophagus/Misdiagnosis/Coronary disease/Oesophageal ulceration分类
医药卫生引用本文复制引用
靳大川,姬广森,杨亚琦,袁晓燕,武淑芳..食管结核误诊分析并文献复习[J].临床误诊误治,2016,29(11):12-15,4.
