The endoscopic diagnosis of colonic tuberculosis

Morgante, P; Gandara, Miguel A.; Sterle, Estaban

doi:10.1016/s0016-5107(89)72724-3

Cited by 12 publications

(6 citation statements)

References 18 publications

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“…Case reports and small retrospective case series have been published describing the endoscopic features of TB of the colon. 11, 12, 13, 14, 15, 16, 17, 18, 20, 21, 31, 32, 33, 34, 35, 36, 37, 38 These features can be non-specific and mimic inflammatory bowel disease or malignancy. As follow-up colonoscopy is not routinely performed after completion of anti-TB treatment, there are limited data on predicting the outcomes of TB lesions, namely, resolution of, lack thereof, or scarring or stricturing of the lumen after healing.…”

Section: Discussionmentioning

confidence: 99%

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Colon Tuberculosis: Endoscopic Features and Prospective Endoscopic Follow-Up After Anti-Tuberculosis Treatment

Mukewar

Ravi

et al. 2012

Clinical and Translational Gastroenterology

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OBJECTIVES:Tuberculosis (TB) is still common in many countries and there has been a resurgence of TB in the developed nations. Although small bowel is the most commonly affected gastrointestinal organ, increasing numbers of cases are being described with colon TB. There are limited prospective studies looking at the outcomes of colon lesions, especially after anti-TB treatment. Our aim was to evaluate the endoscopic features of TB of the colon and to prospectively follow up the endoscopic response of colon lesions to anti-TB treatment.METHODS:From October 2004 to December 2010 consecutive patients presenting with colon TB to one tertiary care center in India were enrolled. Demographic, clinical data, and lesions identified on colonoscopy were recorded. Anti-TB treatment was started and follow-up colonoscopy was performed within 4 weeks after completion of anti-TB treatment. Post-treatment endoscopic features and clinical outcomes were noted.RESULTS:Sixty-nine consecutive patients with colon TB were enrolled (mean age 39.3±14.8 years; male 45, female 24). Presenting clinical features included abdominal pain 80.6%, weight loss 74.6%, fever 40.3%, diarrhea/constipation 25.4%, diarrhea 16.4%, blood per rectum 11.9%, abdominal tenderness 37.3%, abdominal mass 13.4%, and lymphadenopathy 1.5%. Macroscopic lesions on endoscopy were predominantly right-sided (cecum and ascending colon) and primarily ulcers (ulcers 88.0%, nodules 50.7%, luminal narrowing 44.8%, polypoid lesion 10.4%). Majority of the ulcers (87.2%), nodules (84.6%), polypoid lesions (85.7%), luminal narrowing (76.2%), and ileo-cecal valve deformities (76.5%) resolved with anti-TB treatment.CONCLUSIONS:TB of the colon predominantly affects the cecum and the ascending colon. Ulceration, nodularity, and stricture are the prominent endoscopic findings. Majority of the lesions heal with anti-TB treatment.

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Section: Discussionmentioning

confidence: 99%

“…Besides the terminal ileum, several small case series have described TB affecting the colon. 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21 TB of the colon is rare and hence it can be misdiagnosed as colon cancer, inflammatory bowel diseases, ischemic colitis or infectious colitis (also endemic in areas with high prevalence of TB).…”

Section: Introductionmentioning

confidence: 99%

Colon Tuberculosis: Endoscopic Features and Prospective Endoscopic Follow-Up After Anti-Tuberculosis Treatment

Mukewar

Ravi

et al. 2012

Clinical and Translational Gastroenterology

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“…In the present study, well‐formed granulomas were seen in only 18% of the patients, but caseation was not seen in even a single case. It is well known that granulomas may not be seen in mucosal biopsies of nodules, ulcers or other lesions because they are mostly located in the submucosa of the tissue 9 , 38 –40 . Caseation may be absent or be present only in the lymph nodes 1 , 2 , 39 and may not even be found in patients who have received anti‐tuberculous treatment in the past 1 .…”

Section: Discussionmentioning

confidence: 99%

Colonic tuberculosis: Clinical features, endoscopic appearance and management

Misra

Dwivedi

et al. 1999

J of Gastro and Hepatol

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It is concluded that colonoscopy is a useful method for diagnosing colonic tuberculosis. It is suggested that if the clinical picture and colonoscopic appearance are suggestive of tuberculosis and target biopsies reveal non-caseating granulomas, a collection of loosely arranged epithelioid cells, or even non-specific changes, then a therapeutic trial of anti-tuberculous drugs should be given and continued if there is clinical improvement.

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“…2,13,14 However, the endoscopic and histological examination of the involved areas often shows non-specific changes and cultures for TB are frequently negative. 15 In the present patient, because of the life-threatening massive hemorrhage, laparotomy was performed, and she was consequently diagnosed with ileal tuberculosis on the basis of the histological findings of the resected specimen.…”

Section: Discussionmentioning

confidence: 79%

Massive rectal bleeding due to ileal tuberculosis

Watanabe

Kudo

Kayaba

et al. 1999

Journal of Gastroenterology

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A patient with massive rectal bleeding due to ileal tuberculosis is reported. Technetium-99m labelled red blood cell scintigraphy indicated hemorrhage from the ileum, and laparotomy was then carried out. A 70-cm segment of ileum containing ulcers and erosions was resected, and epitheloid granuloma with Langhans-type giant cell was found in the resected specimen. Massive rectal bleeding is considered a rare presenting symptom of intestinal tuberculosis. Intestinal tuberculosis, including small intestinal tuberculosis, although uncommon, should be taken into consideration as a cause of rectal bleeding.

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The endoscopic diagnosis of colonic tuberculosis

Cited by 12 publications

References 18 publications

Colon Tuberculosis: Endoscopic Features and Prospective Endoscopic Follow-Up After Anti-Tuberculosis Treatment

Colon Tuberculosis: Endoscopic Features and Prospective Endoscopic Follow-Up After Anti-Tuberculosis Treatment

Colonic tuberculosis: Clinical features, endoscopic appearance and management

Massive rectal bleeding due to ileal tuberculosis

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