Small bowel tuberculosis diagnosed by the combination of video capsule endoscopy and double balloon enteroscopy

Abstract

Small bowel tuberculosis is sometimes encountered in oriental countries, and because its symptoms are vague and present a nonspecific pattern, confirmative diagnosis is difficult to achieve. In 2001, two new innovative endoscopic techniques for the small bowel, video capsule endoscopy and double balloon enteroscopy, were introduced, thus advancing the diagnostic technology for small bowel disorders. Our asymptomatic patient with small bowel tuberculosis was diagnosed definitively using the combination of video capsule endoscopy and double balloon enteroscopy. The number of such cases will increase when those procedures become more widely used. At present, the endoscopic view of small bowel tuberculosis is difficult to differentiate from Crohn's disease and drug-induced enteropathy, but from now on it will be possible to distinguish them utilizing endoscopic and fluoroscopic images. On the basis of the characteristics of small bowel tuberculosis with its endoscopic images, referring to our case report and previous literature, we report a topical diagnostic procedure, the combination of video capsule endoscopy and double balloon enteroscopy.

Capsule Endoscopy for Obscure Gastrointestinal Bleeding in the Tropics: Report From India

“…[29][30][31] Small bowel tuberculosis was seen in three patients in our series. The CE findings of small bowel tuberculosis have been reported elsewhere as case reports or small series, 32,33 and our study also confirms these findings. Response to antitubercular treatment served as a surrogate marker to confirm the diagnosis of small bowel tuberculosis.…”

Capsule Endoscopy for Obscure Gastrointestinal Bleeding: A Single‑Center Experience

“…CE findings were comparable to previous series described. [23,24] Response to antitubercular treatment served as a surrogate marker to confirm the diagnosis of small bowel tuberculosis. We also found changes of portal hypertension enteropathy in five patients of chronic liver disease with persistent anemia and evidence of chronic blood loss, despite eradication of the esophageal varices and no other bleeding source on upper and lower gastrointestinal endoscopy, with findings similar to those described in literature.…”

Herausforderungen in der Diagnostik der Darmtuberkulose – Pitfalls einer vergessenen infektiösen Erkrankung: Eine Fallserie und Literaturübersicht

“…Für die Biopsieentnahme empfehlen wir aus eigener Erfahrung mit dem ersten Fall (falls es vertretbar ist) für mindestens 2 Wochen zuvor auf eine antibiotische Therapie zu verzichten. Jedoch kann eine Tuberkulose den gesamten Magen-Darm-Trakt betreffen, sodass eine Gastroskopie und eine Dünndarmdiagnostik notwendig werden [32,33].…”