Abdominal tuberculosis in a baby (case report)
DOI: 10.32364/2587-6821-2023-7-5-13
L.V. Poddubnaya1,2, G.F. Dubakova2, T.S. Geleskul2, E.P. Shilova1,2, T.A. Kolpakova1, M.F. Osipenko1, S.D. Nikonov3, V.P. Drobysheva1
1Novosibirsk State Medical University, Novosibirsk, Russian Federation
2Children's Tuberculosis Hospital, the branch of Novosibirsk Regional Clinical Tuberculosis Hospital, Novosibirsk region, Russian Federation
3Novosibirsk Regional Clinical Tuberculosis Hospital, Novosibirsk, Russian Federation
Abdominal tuberculosis is a specific tuberculous lesion of the abdominal organs. In children, abdominal tuberculosis is mostly secondary, occurring mainly in the form of mesadenitis and intestinal tuberculosis. In most cases (63–96%), the process is localized in the ileocecal valve. The article presents a case of untimely diagnosed abdominal tuberculosis with lymph node lesions of the peritoneum and intestines in a child with intrathoracic lymph node tuberculosis of all groups during densification and the calcification onset. The examination (computed tomography) revealed a lesion of the ileocecal valve, while histology of biopsy material taken during colonoscopy showed granulomatous colitis of mycobacterial nature. The leading clinical manifestation was malabsorption syndrome with increased protein-energy undernutrition. The disease pattern was the rare localization of a specific lesion — in the small intestine with the development of jejunal stenosis, which led to a significant disorder of enteral nutrition and the development of malabsorption syndrome with severe trophological insufficiency. The decisive factor in determining the cause of the malabsorption syndrome was laparotomy, which was performed in presented signs of acute intestinal obstruction. In our opinion, an indication for diagnostic laparoscopy in children with abdominal tuberculosis should be considered the enteral nutrition disorder and malabsorption syndrome, which cannot be corrected at the therapeutic process stage.
Keywords: primary generalized tuberculosis, mycobacterium tuberculosis, intestinal tuberculosis, mesadenitis, malabsorption syndrome, jejunal stenosis, computed tomography, histology.
For citation: Poddubnaya L.V., Dubakova G.F., Geleskul T.S., Shilova E.P., Kolpakova T.A., Osipenko M.F., Nikonov S.D., Drobysheva V.P. Abdominal tuberculosis in a baby (case report). Russian Medical Inquiry. 2023;7(5):337–342 (in Russ.). DOI: 10.32364/2587-6821-2023-7-5-13.
About the authors:
Lyudmila V. Poddubnaya — Dr. Sc. (Med.), Associate Professor, Professor of the Department of Phthisiopulmonology, Novosibirsk State Medical University; 52, Krasny ave, Novosibirsk, 630091, Russian Federation; phthisiologist of the Children's Tuberculosis Hospital, the branch of Novosibirsk Regional Clinical Tuberculosis Hospital; 6, Krasnobayev str., Novosibirsk region, dacha village Mochische, 630534, Russian Federation.
Galina F. Dubakova — phthisiologist, Head of the Children's Department of the Children's Tuberculosis Hospital, the branch of Novosibirsk Regional Clinical Tuberculosis Hospital; 6, Krasnobayev str., Novosibirsk region, dacha village Mochische, 630534, Russian Federation.
Tatiana S. Geleskul — phthisiologist, Head of the Children's Tuberculosis Hospital, the branch of Novosibirsk Regional Clinical Tuberculosis Hospital; 6, Krasnobayev str., Novosibirsk region, dacha village Mochische, 630534, Russian Federation.
Elena P. Shilova — Assistant Professor of the Department of Phthisiopulmonology, Novosibirsk State Medical University; 52, Krasny ave, Novosibirsk, 630091, Russian Federation; phthisiologist of the Children's Tuberculosis Hospital, the branch of Novosibirsk Regional Clinical Tuberculosis Hospital; 6, Krasnobayev str., Novosibirsk region, dacha village Mochische, 630534, Russian Federation.
Tatiana A. Kolpakova — Dr. Sc. (Med.), Professor of the Department of Phthisiopulmonology, Novosibirsk State Medical University; 52, Krasny ave, Novosibirsk, 630091, Russian Federation; ORCID iD 0000-0002-9668-806X.
Maria F. Osipenko — Dr. Sc. (Med.), Professor, Head of the Department of Propaedeutics of Internal Medicine, Novosibirsk State Medical University; 52, Krasny ave, Novosibirsk, 630091, Russian Federation; ORCID iD 0000-0002-5156-2842.
Sergey D. Nikonov — Dr. Sc. (Med.), Head of the Department of Gravitational Blood Surgery, Novosibirsk Regional Clinical Tuberculosis Hospital; 14, Vavilov str., Novosibirsk, 630082, Russian Federation.
Vera P. Drobysheva — Dr. Sc. (Med.), Professor of the Department of Hospital Therapy, Novosibirsk State Medical University; 52, Krasny ave, Novosibirsk, 630091, Russian Federation; ORCID iD 0000-0001-7895-2536.
Contact information: Lyudmila V. Poddubnaya, e-mail: podd@ngs.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interests.
Received 30.03.2023.
Revised 24.04.2023.
Accepted 22.05.2023.
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