Gastrointestinal Tuberculosis Presenting as Malnutrition and Distal Colonic Bowel Obstruction

Chakinala, Raja Chandra; Farkas, Zahava C.; Barbash, Benjamin; Haq, Khwaja F.; Solanki, Shantanu; Dworkin, Brad M.

doi:10.14309/00000434-201710001-01419

Cited by 4 publications

(7 citation statements)

References 5 publications

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“…3 The descending colon is the least common site to be involved because of TB, and over the past 2 decades, isolated or segmental TB affecting it exclusively has been reported very sparsely (Table 1). 2,5–14…”

Section: Discussionmentioning

confidence: 99%

Left-Sided Colonic Tuberculosis Presenting as Colonic Stricture: A Rare Presentation of a Common Disease

et al. 2022

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Gastrointestinal tuberculosis (TB) mainly presents as an ileocecal disease, and colonic TB is more often seen with terminal ileal involvement. Isolated involvement of the descending colon by TB is uncommon and usually presents with chronic colitis. An acute presentation as intestinal obstruction because of tubercular stricture of the descending colon has not been reported. We encountered a young woman who presented with features of acute bowel obstruction. On evaluation, she was diagnosed with a case of descending colon stricture with a provisional diagnosis of malignant colonic stricture. Left hemicolectomy was performed, and histopathology revealed it to be tubercular stricture. Antitubercular therapy was given for 9 months, and she is doing well at follow-up. A differential diagnosis of TB at an unusual location should always be considered even when presented with atypical symptoms, especially for patients from the endemic zone of TB.

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Section: Discussionmentioning

confidence: 99%

Left-Sided Colonic Tuberculosis Presenting as Colonic Stricture: A Rare Presentation of a Common Disease

et al. 2022

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“…Regardless of the gastrointestinal portion involved, abdominal pain and systemic symptoms, such as weight loss, fever, and anorexia, are frequent. [7][8][9] Incidence of GI TB is 3% of all extrapulmonary TB, and involvement of the appendix is rare, occurring in only 0.1-3% of GI TB cases. 8,10,11 Appendicular TB is commonly found in young adults with the average age of 30 years old with a greater incidence in women.…”

Section: Case Reportmentioning

confidence: 99%

“…[7][8][9] Incidence of GI TB is 3% of all extrapulmonary TB, and involvement of the appendix is rare, occurring in only 0.1-3% of GI TB cases. 8,10,11 Appendicular TB is commonly found in young adults with the average age of 30 years old with a greater incidence in women. 12 The presentation of appendicular TB can be similar to appendicitis.…”

Section: Case Reportmentioning

confidence: 99%

Appendicular Tuberculosis as Manifestation of Gastrointestinal Tuberculosis: A Case Report

Yuliza

Rosyid

Effendi

et al. 2021

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Introduction: Gastrointestinal tuberculosis (GI TB) is quite rare with 3% incidence of all extrapulmonary involvement. Appendicular TB may occur in 0.1 - 3% of cases. Diagnosis is often difficult because the patient usually complains about chronic abdominal pain and fever. A definite diagnosis is based on histopathological examination of resected specimens from the appendectomy procedure.Case: We present a 37-year-old male patient admitted to the hospital with chronic abdominal pain, fever, nausea, and loss of body weight. The patient never had a persistent cough, hemoptysis, or night sweating. Physical examination showed pain and muscular rigidity in the right iliac area during palpation with Blumberg's sign and Rovsing's sign positive. Abdomen ultrasound imaging showed an appendicular abscess. The patient underwent appendectomy afterwards with histopathology result showing TB. The patient was treated with first category anti-tuberculosis drugs (ATD).Discussion: Diagnosis of appendicular TB is difficult due to unspecific clinical presentations. Appendicular TB patients often complain of signs and symptoms which are similar to acute appendicitis. These conditions can delay ATD treatment because the definitive diagnosis could be made after histopathological examination.Summary: Appendicular TB is a rare case of extrapulmonary TB. It can present as acute appendicitis. The definitive diagnosis is based on the histopathological examination. It is recommended to check the appendicectomy specimens histopathologically to exclude TB or other diseases.

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“…1 Extrapulmonary TB (EPTB) accounts for 15% to 20% of TB cases in immunocompetent patients worldwide but is higher in developing countries such as the Philippines. 2–4…”

mentioning

confidence: 99%

“…1 Extrapulmonary TB (EPTB) accounts for 15% to 20% of TB cases in immunocompetent patients worldwide but is higher in developing countries such as the Philippines. [2][3][4] GITB is the sixth most common EPTB after lymphatic, genitourinary, bone, miliary, and central nervous system TB. 5,6 It constitutes about 10% of EPTB.…”

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confidence: 99%

Surgical Management of Patients With GI Tuberculosis

Limpin

Lopez

Maglangit

et al. 2022

Diseases of the Colon &Amp; Rectum

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BACKGROUND: The Philippines ranks 10th in tuberculosis prevalence worldwide. Aside from pulmonary tuberculosis, GI tuberculosis remains an important cause of morbidity and mortality, particularly in endemic areas. OBJECTIVE: This study aimed to describe the clinicopathologic profile and surgical outcomes of patients with GI tuberculosis. DESIGN: Retrospective descriptive study. SETTING: Department of Surgery at the Philippine General Hospital, Manila, Philippines. PATIENTS: This study included all newly diagnosed cases of GI tuberculosis from January 1, 2009, to December 31, 2019. MAIN OUTCOME MEASURES: Clinical response to surgery. RESULTS: A total of 241 confirmed new cases were managed during an 11-year period. Of these, 208 patients (86.30%) underwent outright surgery, whereas the remaining patients (13.69%) received antituberculous therapy. Fifteen medically managed patients eventually required surgery, bringing the total surgically managed patients to 223. The patients’ age ranged from 19 to 72 years, with a 1.9:1 male to female ratio. The most common complaint was abdominal pain. Intestinal obstruction was the most common indication for surgery. A right hemicolectomy was the most often performed procedure, with the ileocecal area as the most frequently involved segment. The most common histopathologic findings were epithelioid granuloma and caseation necrosis. Postoperative length of stay ranged from 0 to 59 days (mean, 7 days). Morbidity rate was 5.38% and mortality rate was 3.14%. Four deaths were operative and resulted from septic shock because of hollow viscus perforation. LIMITATIONS: This study was limited to histopathologic basis for diagnosis. CONCLUSION: The recommended initial therapy for all forms of extrapulmonary tuberculosis is a 6-month regimen of antituberculous therapy unless the organisms are known or suspected to be resistant to first-line drugs. Surgery is reserved for complications of intra-abdominal tuberculosis: obstruction, perforation, or severe bleeding. Timely surgical intervention, coupled with medical management led to the best outcomes for these patients. See Video Abstract at http://links.lww.com/DCR/C56. MANEJO QUIRÚRGICO DE PACIENTES CON TUBERCULOSIS GASTROINTESTINAL ANTECEDENTES: Las Filipinas ocupa el décimo lugar en prevalencia de tuberculosis en todo el mundo. Aparte de la tuberculosis pulmonar, la tuberculosis gastrointestinal sigue siendo una causa importante de morbilidad y mortalidad, especialmente en las zonas endémicas. OBJETIVO: Este estudio tuvo como objetivo describir el perfil clinicopatológico y los resultados quirúrgicos de pacientes con tuberculosis gastrointestinal. DISEÑO: Estudio descriptivo retrospectivo. AJUSTE: Departamento de Cirugía del Hospital General de Filipinas, Manila, Filipinas. PACIENTES: Todos los casos de tuberculosis gastrointestinal recién diagnosticados desde el 1 de Enero del 2009 hasta el 31 de Diciembre del 2019. MEDIDAS DE RESULTADO PRINCIPAL: Respuesta clínica a la cirugía. RESULTADOS: Se manejaron un total de 24...

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Gastrointestinal Tuberculosis Presenting as Malnutrition and Distal Colonic Bowel Obstruction

Cited by 4 publications

References 5 publications

Left-Sided Colonic Tuberculosis Presenting as Colonic Stricture: A Rare Presentation of a Common Disease

Left-Sided Colonic Tuberculosis Presenting as Colonic Stricture: A Rare Presentation of a Common Disease

Appendicular Tuberculosis as Manifestation of Gastrointestinal Tuberculosis: A Case Report

Surgical Management of Patients With GI Tuberculosis

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