ABSTRACT Our objective was to evaluate the incidence of colorectal tuberculosis in our series and to study its radiological spectrum. A total of 684 cases of proven gastrointestinal tuberculosis with positive barium contrast findings seen over a period of more than one decade were evaluated. The study did not include cases where colon was involved in direct contiguity with ileo-caecal tuberculosis. Seventy-four patients (10.8%) had colorectal tuberculosis. Commonest site involved was transverse colon, closely followed by rectum and ascending colon. Radiological findings observed were in the form of strictures (54%), colitis (39%) and polypoid lesions (7%). Complications noted were in the form of perforations and fistulae in 18.9% of cases. Colorectal tuberculosis is a very common site for gastrointestinal tuberculosis. Typical findings of colorectal tuberculosis are strictures, signs of colitis and polypoid lesions. Common complications are perforation and fistulae.
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ABSTRACT: 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. 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. 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. 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.Clinical and translational gastroenterology. 01/2012; 3:e24.
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ABSTRACT: Isolated colonic tuberculosis (TB) is rare, and the symptoms are nonspecific making early diagnosis and management difficult. Although colonoscopy and biopsy is an important diagnostic modality, the features are variable and the distinction from other conditions of the colon, especially Crohn's disease and cancer, may be impossible without surgical resection. We report a case of ascending colon TB which was mistaken for colonic cancer during colonoscopy, with non-specific results on biopsy. The diagnosis was finally made when the histopathology report was received. The diagnostic dilemma of colonic TB is discussed.Journal of surgical case reports. 01/2012; 2012(5):10.
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ABSTRACT: Gastrointestinal tuberculosis occurs most often in the ileocecal region, but it can also occur in other locations in the gastrointestinal system. However, few cases with isolated gastrointestinal involvement have been reported. A 27-year-old female presented with abdominal pain, fatigue, weakness, weight loss, and anorexia. A mass was identified in her right lower abdominal quadrant on physical examination. Abdominal computed tomography (CT) showed a thickened right colon wall with marked narrowing of the lumen, and mucosal ulcers at the hepatic flexure and circular narrowing of the lumen 10cm distal to these lesions were identified on colonoscopic examination. Laparoscopic right hemicolectomy was performed due to the fact that malignancy could not be rule out. Gastrointestinal tuberculosis is often confused with inflammatory diseases, and even histopathological diagnosis is difficult in most cases. In addition to this, differentiation between malignancies and infectious diseases is also necessary.Journal of Surgery. 12/2013; 1(1):15-18.