Tuberculous ileo-colitis in Ibadan: a clinico-radiological review

Abstract

SUMMARY Twenty cases of tuberculous ileo-colitis with radiographic changes seen in the University College Hospital, Ibadan, Nigeria, are reviewed and the clinical features and radiographic patterns examined. The intestinal lesions in all cases were secondary to healed and active pulmonary tuberculosis.Although the ileo-caecal region is the commonest site of involvement, lesions also occurred in the distal part of the colon and the entire colon was sometimes involved. Rare occurrences, such as the diverticular type, enterolithiasis, tuberculosis presenting as intussusception and as an appendicular mass, are also reported. Four principal radiological types of colonic change emerged from the study, namely, the hyperplastic, the ulcerative, the mixed ulcero-hyperplastic, and the carcinoma-like types.

Clinicopathological Profile of Abdominal Tuberculosis

“…Hoon et al considered radiological examination to be the single most important investigation for establishing the diagnosis of abdominal tuberculosis 18 . Others have not considered barium contrast studies useful 19 , 20 . Although no pathognomonic radiological signs of intestinal tuberculosis exist, a barium contrast study is often rewarding and may alert the astute clinician and radiologist to the possibility of intestinal tuberculosis 7 , 21 , 22 .…”

Enteroclysis of non-neoplastic disorders of the small intestine

“…It may be impossible to differentiate tuberculosis from Crohn's disease. Segmental distribution with normal areas in between (skip lesions) similar to those of Crohn's disease are sometimes seen [27]. Patients with tuberculosis may present with acute intestinal obstruction, an uncommon initial presentation in Crohn's disease.…”

“…Histological examination of peroral jejunal biopsy specimens shows dilatation of the submucosal lymphatics. On enteroclysis D. J. Nolan: Enteroclysis of non-neoplastic disorders of the small intestine 350 27 28 a 28 b 29 Fig. 27.…”

Jejunal absorption rates of glucose, glycine and glycylglycine in Zambian African adults with malnutrition

“…It is not clear therefore why weight loss was so gross; it seems unlikely that it was entirely associated with hypercatabolism associated with the infection. Tuberculous ileo-colitis is a relatively common disease in Africa (Francis, 1972;Lewis & Kolawole, 1972) and is probably under-diagnosed. Subject 3 had disseminated Kaposi's sarcoma (Taylor & Kyalwazi, 1972).…”