Абдоминальный туберкулез у ребенка раннего возраста (клиническое наблюдение)

Abstract

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.