Tuberculosis terminal ileitis: A forgotten entity mimicking Crohn’s disease

Gurzu, Simona; Molnar, Călin; Contac, Anca Otilia; Fetyko, Annamaria; Jung, Ioan

doi:10.12998/wjcc.v4.i9.273

Cited by 10 publications

(5 citation statements)

References 29 publications

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“…Granulomas in ITB are more confluent with lymphoid cuffing and disproportionate amounts of submucosal inflammatory cell infiltrate and may show caseation necrosis; granulomas of CD show a more discrete distribution. Both ITB and CD further progress to show transmural involvement of the bowel wall 16,23,24 . Radiologically, the initial mucosal involvement in ITB and CD with associated submucosal inflammation may be responsible for the mucosal hyperenhancement and stratification as observed in the SMH pattern on CTE 25 .…”

Section: Discussionmentioning

confidence: 99%

Systematic reporting of computed tomography enterography/enteroclysis as an aid to reduce diagnostic dilemma when differentiating between intestinal tuberculosis and Crohn's disease: A prospective study at a tertiary care hospital

Israrahmed

Yadav

et al. 2020

JGH Open

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Background and AimCrohn's disease (CD) and intestinal tuberculosis (ITB) have similar symptomatology and overlapping features on imaging, endoscopy, and histopathology. It is important to differentiate ITB from CD to initiate correct medical management. This prospective study aimed to characterize imaging features on computed tomography enteroclysis/enterography (CTE) that help in differentiating ITB from CD.MethodsA total of 300 consecutive patients who underwent CTE with the suspicion of small bowel diseases were evaluated. CTE findings were documented on a detailed “CTE case record form” and were correlated with other investigations like endoscopy, histopathological and microbiological examination, and improvement on empirical therapy to arrive at a final diagnosis. Only confirmed cases of ITB/CD were included for further analysis.ResultsFinal diagnoses revealed that 61 patients had ITB, 24 had CD, 90 patients had a final diagnosis not related to ITB/CD, and 125 had no bowel‐related diseases. The sensitivity of CTE (ITB vs CD, 90.2 vs 91.6%) was higher than the sensitivity of ileocolonoscopy (ITB vs CD, 87 vs 83.3%). A homogenous pattern of bowel wall thickening and confluent bowel involvement were significantly more common in ITB. Stratified bowel wall thickening with mucosal hyperenhancement, skip lesions in the bowel, and a comb sign were significantly more common in CD. Stratified bowel wall enhancement with an intervening layer of fat was specifically (P < 0.001) seen in patients with CD, and necrotic (P = 0.002) and calcified (P = 0.055) lymph nodes were specifically seen in patients with ITB.ConclusionWe propose a systematic approach to the radiological differentiation of ITB from CD.

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Section: Discussionmentioning

confidence: 99%

Systematic reporting of computed tomography enterography/enteroclysis as an aid to reduce diagnostic dilemma when differentiating between intestinal tuberculosis and Crohn's disease: A prospective study at a tertiary care hospital

Israrahmed

Yadav

et al. 2020

JGH Open

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“…Crohn's disease may also show loss of the bowel wall layers, creeping fat, strictures, and other complications of inflammatory bowel disease,[ 8 ] but ultrasound may not be able to distinguish between infectious and inflammatory bowel disease. In susceptible patients, tuberculosis can also cause terminal ileitis[ 9 ] [ Figure 2 ].…”

Section: T Erminal I Leitismentioning

confidence: 99%

Right Iliac Fossa Pain other than Appendicitis

Goudie

2023

Journal of Medical Ultrasound

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Right iliac fossa pain is a common presentation. Although appendicitis is the most common surgical emergency, many other pathologies can have similar presentations and should be considered. This review describes the findings and shows examples of conditions other than appendicitis that should be examined for in a patient who presents with right iliac fossa pain, particularly if the appendix is not seen or seen to be normal.

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“…A 53-year-old patient in Romania lost his life after having intestinal TB that was mistakenly identified as Crohn's disease. 31…”

Section: Underutilization Of Postmortem Microbiologymentioning

confidence: 99%

The Underutilization of Forensic Microbiology: A Narrative Review

Saha,

Kaushik,

Kumar

et al. 2023

ANAMS

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One of the main reasons of death in India is infection. At many centers, determining the infectious cause of death during autopsy is not regularly done. Although it is still a neglected field, postmortem microbiology has the potential to be a crucial tool for identifying the reason and circumstances of unexpected death. In addition to its use in forensic autopsies and medicolegal investigations, this tool can help with the detection of novel pathogen presentations, estimation of drug resistance, identification of bioterrorism agents, and a better understanding of infectious diseases like toxic shock syndrome, Human Immunodeficiency Virus (HIV), and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). In India, there has not been much use of microbiology in postmortem, and there is a dearth of specific guidelines or recommendations by regulatory agencies.In an effort to highlight the value of microbiology in postmortem, this narrative review focusses on suggestions made by a group of academicians from Europe in February 2016 and how they may be used in an Indian context. Based on the Indian Council of Medical Research and the Centers for Disease Control and Prevention standards, we have briefly discussed about postmortem in coronavirus disease 2019 related deaths.

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Tuberculosis terminal ileitis: A forgotten entity mimicking Crohn’s disease

Cited by 10 publications

References 29 publications

Systematic reporting of computed tomography enterography/enteroclysis as an aid to reduce diagnostic dilemma when differentiating between intestinal tuberculosis and Crohn's disease: A prospective study at a tertiary care hospital

Systematic reporting of computed tomography enterography/enteroclysis as an aid to reduce diagnostic dilemma when differentiating between intestinal tuberculosis and Crohn's disease: A prospective study at a tertiary care hospital

Right Iliac Fossa Pain other than Appendicitis

The Underutilization of Forensic Microbiology: A Narrative Review

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