How should intestinal tuberculosis be examined?

As a disease of the digestive system, intestinal tuberculosis is a torture for patients because when intestinal tuberculosis occurs, patients will experience symptoms such as fever and diarrhea. There are currently several methods for examining intestinal tuberculosis in hospitals. You may want to take a look.

Differential diagnosis

The diagnosis of typical cases is generally not difficult. However, in the early stages of the disease, it is often missed because the symptoms are not obvious or lack characteristic features. The following points can be used as the basis for diagnosing this disease.

1. Young and middle-aged patients with clinical manifestations including long-term fever, night sweats, abdominal pain, diarrhea (or constipation).

2. Patients with pulmonary tuberculosis or other extraintestinal tuberculosis whose original lesions have improved, but whose gastrointestinal symptoms and tuberculosis septicemia symptoms have worsened.

3. Patients with a mass in the right lower abdomen accompanied by tenderness, or symptoms of incomplete intestinal obstruction of unknown cause.

4. Gastrointestinal X-ray examination shows signs of irritation, barium filling defect or stenosis in the ileocecal region.

Testing

Laboratory and other tests:

1. The blood picture and the total white blood cell count are generally normal, the lymphocyte count is often high, and the red blood cell and hemoglobin are often low, showing mild to moderate anemia, which is more common in ulcer patients. In patients with active disease, the ESR is often elevated.

2. Stool examination: There are usually no obvious changes in stool examination of hyperplastic intestinal tuberculosis. Microscopic examination of stool of ulcerative intestinal tuberculosis may reveal a small amount of pus cells and red blood cells. Concentrating stool to look for tuberculosis bacteria is only meaningful when the sputum is negative.

3. X-ray examination X-ray barium meal or barium enema examination is of great significance for the diagnosis of intestinal tuberculosis. Patients with concurrent intestinal obstruction should only undergo barium enema to prevent the barium meal examination from aggravating the obstruction. The intestinal segments of ulcerative intestinal tuberculosis are often irritated, the barium is emptied quickly, and the filling is poor. The intestinal segments above and below the lesion are well filled with barium, which is called the skip sign. Signs such as hyperplastic intestinal tuberculosis. When there is intestinal obstruction, the proximal intestinal flexure is often significantly dilated.

4. Fiber colonoscopy can directly observe lesions in the entire colon, cecum and ileocecal region, and can perform biopsy or take samples for bacterial culture.