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1.
Z Gastroenterol ; 50(3): 288-92, 2012 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-22383285

RESUMO

Here we present 3 patients with abdominal pain, weight loss and fever in combination with abdominal tumours which were all attributable to an ongoing mycobacterial infection. Worldwide, but especially in developing countries, tuberculosis is still an important cause of morbidity and death. In industrialised countries, however, tuberculosis is rarely considered as a differential diagnosis, especially when the primary lesion is not localised in the lung. Primary abdominal manifestations, in particular, are a frequent cause of delayed diagnosis due to the often elaborated necessary diagnostics. Once the diagnosis has been established, a combination therapy starting with isoniazid, rifampicin, pyrazinamide and ethambutol, i. e., the standard therapeutic regimen for pulmonary tuberculosis, is recommended. Concomitant diseases and atypical courses, however, often constitute serious challenges to the treating physician. Therefore, we here give a review of the literature and discuss three cases of abdominal tuberculosis with regard to clinical characteristics, diagnostic pitfalls and courses of disease.


Assuntos
Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/diagnóstico , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Raras/complicações , Doenças Raras/diagnóstico
2.
Radiologe ; 47(5): 411-20, 2007 May.
Artigo em Alemão | MEDLINE | ID: mdl-16440190

RESUMO

Based on the observations in four girls suffering from constant urinary dribbling we analyzed the special features and difficulties in making the diagnosis of an ectopic ureter. In all patients there was marked diagnostic delay. In one symptomatic case the abnormality was not detected before the age of 18 years. Failure to recognize the characteristic signs and symptoms played a crucial role in delaying the diagnosis. Moreover, imaging of ureteral ectopia represents a diagnostic challenge. The ectopic ureters were associated with dysplastic, poorly functioning renal moieties. Common diagnostic imaging procedures, such as ultrasound, intravenous pyelography, or voiding cystourethrography yielded incomplete diagnostic information and often failed to provide a definitive diagnosis. The latter could only be obtained with MR urography. We assessed the diagnostic value of the different examinations and compared our findings with those reported in the literature.


Assuntos
Coristoma , Rim Displásico Multicístico , Ureter , Transtornos Urinários/etiologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Coristoma/diagnóstico , Coristoma/diagnóstico por imagem , Coristoma/cirurgia , Feminino , Humanos , Imageamento por Ressonância Magnética , Rim Displásico Multicístico/diagnóstico , Rim Displásico Multicístico/diagnóstico por imagem , Cintilografia , Tomografia Computadorizada por Raios X , Ultrassonografia , Urografia
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