ABDOMINALNI TBC LIMFADENITIS I MULTIDISCIPLINARNA SARADNJA - PRIKAZ SLUČAJA

Nadarević A 1,Avdić S 2,Pranjić N 3
1 JZU Dom Zdravlja Tuzla, Poliklinika za plućne bolesti i tbc, Bosna i Hercegovina ˛
2 JZU Dom Zdravlja Tuzla Poloklinika za unutrašnje bolesti, Bosna i Hercegovina
3 JZU Dom Zdravlja Tuzla, Služba medicine rada, Bosna i Hercegovina

Tuberkuloza limfnih čvorova se rijetko javlja, ali stoga predstavlja terapeutski i dijagnostički problem. Najčešće oboljevaju djeca i žene. Bolest pokazuje tendenciju ponavljanja i zahtijeva brz terapeutski tretman.

CILJ: Cilj rada je da se prikaže slučaj TBC- oboljenja limfnih čvorova abdomena u 18 godina stare djevojke, studenta Pravnog fakulteta. Na slučaj je ukazao pulmolog, prilikom pažljivog očitavanje rendgen snimka pluća, te uputio pacijenta na hitan ultra-zvučni pregled gornjeg abdomena. Pacijentica je imala povišenu temperature, malaksalost i iscrpljenost više sedmica, nepoznate etiologije. Slika je u početnoj fazi ličila na upalni proces pleure.

PRIKAZ: Ventralnim i dorzalnim ultrazvučnim pregledom gornjeg abdomena se otkriju: suspektna tvorba veličine 34x47mm, potom mjestimično velika ehogenija mjesta, otvorene etiologije. Potom se učine i druge dijagnostičke procedure: CT abdomena, CT grudnog koša, biopsija limfnih čvorova. Ispostavilo se da je ovo bio slučaj uvoda u teški oblik abdominalnog TBC limfadenitisa. Uključivanjem anti-TBC terapije, pacijentica se osjećala bolje, ponovljeni nalazi SE, CRP, i fibrinogena su se postepeno vraćali referentnim.

ZAKLJUČAK: Kada se postavi dijagnoza i sprovede liječenje, treba uvijek razmišljati da se TBC bolest može ponoviti u još težoj formi. Multidisciplinarna saradnja u medicinski komplikovanim i rijetkim slučajevima je neophodna i veoma važna. Rad upravo tretira slučaj u kome je došla do izražaja pravovremena multidisciplinarna saradnja.

ABDOMINAL LIMPHADENITIS CAUSED BY MTB AND MULTIDISCIPLINARY APPROACH -CASE REPORT

Nadarević A ą, Avdić S˛, Pranjić N ł.
1 Policlinic for pulmonary diseases and TBC, Bosnia and Hercegovina
2 Public Health Centre Tuzla, Policlinic for Internal disease, Bosnia and Hercegovina
3 Public Health Centre Tuzla, Institution of Occupational Medicine, Bosnia and Hercegovina

Tuberculosis of limp's knot shows less epidemically, as well as more diagnostically therapy problem. They often appear at children and women. Illness shows tendency to repeat in spite of neat treatment.

AIM: In our work we described the TB of a limp's knots in abdomen at 18 years old girl. The main symptoms of disease were weakness, exhaustion, raise fever. Besides the basic symptoms: increased body temperature, pain under the right rib, nausea, and already diagnosed and signs of acute TB process of pleura, and the healthy state of patients worsted.

REPORT: Than we made ventral ultrasound examine of abdomen from blood vessel cave, and dorsal ultrasound examine from the head of pancreas, and found a structure of 34x47mm, and in some parts of cross sections some bigger homogeneous and smaller not homogeneous part, opened aetiology. After this came, the patient is submitted next others diagnostic examination: CT of abdomen, CT of chest and a biopsy of limp's knots. The examination showed moderation reissued to reissued SE, positive CRP and reissued fibrinogen. After we have done the anti- TB therapy, patient felt better, and the treatment was stopped with a recommendation to answer regular medical cheeks.

CONCLUSION: All patients must be considerate and basic examined from own doctor. The doctor in important moment has diagnostical help from other collegues. Whan found the diagnosesand made treatment, should be ever think about return TB disease in many dificult form. Multidisciplinary collaboration in medicine is complicated and in is rare case it is also very important and necessary.

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