The Role of Colonoscopy in the Diagnosis of Tuberculosis

Kalvaria, I; Kottler, R. E.; Marks, I. N.

doi:10.1097/00004836-198810000-00008

Cited by 31 publications

(15 citation statements)

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“…Inflammatory processes could result in consequent edema, cellular infiltration, and lymphatic hyperplasia. Over time, patients may develop submucosal noncaseating granulomas, mucosal ulceration, necrosis, fibrosis, and stricture formation (2). Furthermore, only 20-25% of the patients with intestinal tuberculosis have concomitant active pulmonary tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Cecal Tuberculosis Mimicking Submucosal Tumor

et al. 2016

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A 41-year-old man presented with abdominal fullness in late August 2012. Abdominal CT showed ileus caused by stenosis of the ileum and an enlargement of the ileocecal lymph nodes. Colonoscopy showed a steep elevated protruding tumor in the cecum, with multiple ulcerative lesions on top. A pathological analysis of the lesions confirmed chronic inflammatory infiltration and epithelioid granuloma. The findings of a tuberculin skin test and QuantiFERON-TB-Gold test were positive. As a result, we treated the patient for tuberculosis of the cecum. After 4 months of treatment, colonoscopy confirmed the disappearance of the tumor. In conclusion, intestinal tuberculosis should be considered in the differential diagnosis when protruding lesions appear in the cecum.

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Section: Discussionmentioning

confidence: 99%

Cecal Tuberculosis Mimicking Submucosal Tumor

et al. 2016

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“…(36) The changes caused by acute inflammation of the colonic mucosa namely oedematous mucosa, mucosal ulceration and nodularity, luminal narrowing, strictures and pseudopolyps can occur in both conditions. (37) All patients received conventional antitubercular therapy for at least 6 months including initial 2 months of rifampicin, isoniazid, pyrazinamide and ethambutol, followed by 4 months of isoniazid and rifampicin as per the revised criteria for national tuberculosis control programme. 61% of our patients responded to 6 months course of ATT.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Colonoscopic Profile of Isolated Colonic Tuberculosis at a Tertiary Care Hospital in North India

Chandail¹,

Jamwal²

2016

jemds

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BACKGROUNDTuberculosis (TB) is one of the oldest diseases known to affect humans and a major cause of death worldwide. According to World Health Organization, incidence of TB is approximately 9.4 million cases per year, of which 1.98 million cases are from India and close to 500,000 per year die of the disease in India. It has been estimated that 2-3% of patients with abdominal TB have isolated colonic involvement. The diagnosis of intestinal TB is a challenge for physicians due to its diverse clinical manifestations that mimic other infectious diseases, autoimmune, and neoplastic disorders and therefore, a high index of suspicion is essential to reach the correct diagnosis. MATERIALS AND METHODSThis was a retrospective analysis of colonoscopic findings of patients with isolated colonic tuberculosis who presented between April 2015 -July 2016. All the patients above 18 years of age with suspected diagnosis of intestinal tuberculosis were included in the study. Patients with ulcerative colitis, Crohn's disease, microscopic colitis and indeterminate colitis or carcinoma colon, HIV positive patients were excluded from the study. These patients were taken up for colonoscopy and distal ileoscopy after proper preparation. The findings observed in any part of the colon with particular reference of any aphthous ulcers, granularity, deep ulcers, nodules, polypoidal lesions and luminal narrowings were recorded. A confirmed diagnosis of isolated colonic tuberculosis was made when there were caseating granulomas and or acid fast bacilli on biopsy samples. A suspected diagnosis was made when there was clinical suspicion, with family history of colonic tuberculosis, biopsy showing noncaseating granulomas with chronic inflammation and response to antitubercular therapy. Those patients who had confirmed or suspected diagnosis of isolated colonic tuberculosis were started on antitubercular therapy for a period of 6 months. RESULTSThe data of a total of 43 patients was retrieved from the records for this study. Out of these 43 patients, 6 patients were lost to followup. A total of 3 patients did not respond to the antitubercular treatment and were subsequently diagnosed as Crohn's disease on further evaluation. Finally, a total of 34 patients were evaluated in this study, out of which 22 were males and 12 were females. The minimum age in all these patients was 18 years with a maximum age of 79 years. The most common symptom of presentation was pain abdomen (91.17%) followed by anorexia (88.23%), Fever (73.52%), weight loss (70.58%), chronic diarrhoea (52.94%), constipation (26.47%) patients, mass abdomen (20.58%) and bleeding per rectum (14.70%) of patients. The colonoscopic findings were aphthous ulcers in 18 (52.94%), deep ulcers in 16 (47.05%), nodules in 19 (55.88%), luminal narrowing in 8 (23.52%) and polypoidal lesions in 5 (14.70%) of patients. The commonest site involved in our patients with isolated colonic tuberculosis was ileocecal valve with caecum in 29 (84.29%) of patients, followed by isolated ascending co...

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“…Inflammatory processes ensue with consequent edema, cellular infiltration and lymphatic hyperplasia. Over longer periods of time patients may develop submucosal noncaseating granulomas, mucosal ulceration, necrosis, fibrosis and stricture formation [14]. Grossly, ITB can present with ulceration, hypertrophy of the bowel wall, a combination of ulceration and hypertrophy, or fibrotic stricture formation [15].…”

Section: Discussionmentioning

confidence: 99%

Case of intestinal tuberculosis mimicking Crohn’s disease

et al. 2012

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SummaryBackground:Intestinal tuberculosis can closely mimic Crohn’s disease and colon cancer. Presented here is a case of intestinal tuberculosis that closely mimicked both.Case Report:A 23 year old Hispanic female presented with several months of weight loss, recurrent fever, and emesis. The patient did not have pulmonary symptoms or radiographic evidence of tuberculosis. Colonoscopy evaluation with biopsy of the affected bowel segments were thought to be consistent with either colon cancer or Crohn’s Disease. Acid fast bacilli staining and histological analysis did not display evidence of tuberculosis on two separate occasions. The patient developed colonic obstruction acutely during the course of treatment requiring resection of the affected bowel segment. Acid fast staining of the resected lymph nodes was positive and submucosal caseating granulomas were identified histologically, consistent with intestinal tuberculosis.Conclusions:Intestinal tuberculosis remains a diagnostic challenge. Consideration of the disease should be maintained in equivocal cases.

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The Role of Colonoscopy in the Diagnosis of Tuberculosis

Cited by 31 publications

References 0 publications

Cecal Tuberculosis Mimicking Submucosal Tumor

Cecal Tuberculosis Mimicking Submucosal Tumor

Clinical and Colonoscopic Profile of Isolated Colonic Tuberculosis at a Tertiary Care Hospital in North India

Case of intestinal tuberculosis mimicking Crohn’s disease

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