结核性腹膜炎TuberculousP

Peritonitisn.腹膜炎

Deaminasen.脱氨酶

Peritoneumn.腹膜

Mesentericadj.肠系膜的

Laparoscopyn.腹腔镜

胆囊切除术Cholecystectomy

Omentumn.网膜

Granulomasn.肉芽肿

Apreviouslyhealthy24-year-oldmanpresentedtotheemergencydepartmentwitha1-monthhistoryofabdominaldistention,abdominalpain,andfever.Onphysicalexamination,hewasnotedtohavebulgingflankswithafluidwave.Analysesofasciticfluidrevealedapredominanceoflymphocytes,ahighproteinlevelthatwassimilartothatinserum,andanadenosinedeaminaselevelofUperliter.Theresultsofacid-faststainingandpolymerase-chain-reaction(PCR)testingforMycobacteriumtuberculosiswerenegative.ACTscanobtainedshowedalargeamountofascites,athickenedperitoneum,andmultipleenlargedmesentericlymphnodes.Exploratorylaparoscopyrevealednumerouswhite,miliarynodulesontheperitoneumandomentum.CaseatinggranulomaswithLangerhansgiantcellsweredetectedonperitonealhistopathologicalanalysis.Aspecimenofanomentallesionwasobtainedonbiopsy,andtheresultsofPCRtestingandcultureofthetissuewerepositiveforM.tuberculosis.Thesensitivityofascitic-fluidcultureforM.tuberculosisislow,andthediagnosiscanrequireperitonealbiopsy.1

一名24岁既往健康男性患者因腹胀、腹痛和发烧1月于急诊室就诊。体格检查发现侧腹膨隆伴有液波。腹水分析显示淋巴细胞为主，蛋白水平升高与血清蛋白水平相似，腺苷脱氨酶为每升单位。结核分枝杆菌抗酸染色和聚合酶链反应检测结果均为阴性。CT扫描显示大量腹水、腹膜增厚和多个增大的肠系膜淋巴结。腹腔镜探查显示腹膜和网膜上许多白色的粟粒状结节。腹膜组织病理学分析显示有朗格汉斯巨细胞的干酪性肉芽肿。通过组织活检获得的网膜病变标本，经PCR检测和组织培养出结核分枝杆菌。腹水培养对结核分枝杆菌的敏感性较低，诊断可能需要腹膜活检。

1.常用医学词组

abdominaldistention腹胀

abdominalpain腹痛

asciticfluid腹水

adenosinedeaminase腺苷脱氨酶

结核性心包炎TuberculousPericarditis

acid-faststaining抗酸染色

polymerasechainreaction(PCR)

聚合酶链反应

Mycobacteriumtuberculosis

结核分枝杆菌

mesentericlymphnode肠系膜淋巴结

Caseatinggranulomas干酪性肉芽肿

Langerhansgiantcells朗汉斯巨细胞

peritonealhistopathologicalanalysis

腹水组织病理分析

ascitic-fluidculture腹水培养

peritonealbiopsy腹腔穿刺

今天音频最后两句话留给大家，提示的是四个抗结核药物isoniazid，rifampin，ethambutol，和pyrazinamide，这些单词在手指结核TuberculosisoftheFinger里面也出现了。

下面是昨天的听写文本和我自己的翻译：

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