Importance of ileoscopy during colonoscopy for the early diagnosis of ileal tuberculosis: Report of two cases

Department of Medicine, Department of Pathology, Alice Ho Miu Ling Nethersole Hospital, Tai Po, New Territoties, Hong Kong SAR.
Gastrointestinal Endoscopy (Impact Factor: 5.37). 07/2001; 53(7):813-5. DOI: 10.1067/mge.2001.114954
Source: PubMed
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    ABSTRACT: Gastrointestinal tuberculosis is defined as infection of the peritoneum, hollow or solid abdominal organs, and abdominal lymphatics with Mycobacterium tuberculosis organisms. Gastrointestinal tuberculosis is relatively rare in the United States and is the sixth most common extrapulmonary location. Populations at risk include immigrants to the United States, the homeless, prisoners, residents of long-term care facilities, and the immunocompromised. The peritoneum and the ileocecal region are the most likely sites of infection and are involved in the majority of cases by hematogenous spread or through swallowing of infected sputum from primary pulmonary tuberculosis. Pulmonary tuberculosis is apparent in less than half of patients. Patients usually present with abdominal pain, weight loss, fever, anorexia, change in bowel habits, nausea, and vomiting. The diagnosis is often delayed and is usually made through a combination of radiologic, endoscopic, microbiologic, histologic, and molecular techniques. Antimicrobial treatment is the same as for pulmonary tuberculosis. Surgery is occasionally required.
    Current Gastroenterology Reports 09/2003; 5(4):273-8. DOI:10.1007/s11894-003-0063-1
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    ABSTRACT: Colonoscopy with terminal ileoscopy is crucial for the diagnosis of intestinal tuberculosis. This report describes characteristic endoscopic findings in patients with intestinal tuberculosis with few or no clinical symptoms. Data for 11 consecutive patients in whom a diagnosis of intestinal tuberculosis was made during the last 15 years in one facility were reviewed. Clinical findings and the frequency of endoscopic findings were evaluated. Mucosal lesions were classified into 4 types: type 1, circumferential ulceration with nodules; type 2, round or irregularly shaped small ulcers, arranged circumferentially, without nodules; type 3, multiple erosions restricted to the large intestine; and type 4, small ulcers or erosions restricted to the ileum. The gross endoscopic appearance of healed lesions included patulous ileocecal valve, pseudodiverticular deformity, and atrophic mucosal areas with aggregated ulcer scars. Only one patient had remarkable clinical symptoms (anorexia and weight loss), whereas, the other 10 had few or no symptoms. The frequency of type 1, 2, 3, and 4 endoscopic findings was, respectively, 36%, 36%, 9%, and 18%. The frequencies for patulous ileocecal valve, pseudodiverticular deformity, and atrophic mucosal area were, respectively, 45%, 45%, and 91%. When colonoscopy is performed in asymptomatic patients, it is important to be aware of subtle endoscopic findings that are characteristic for intestinal tuberculosis. Recognition of such findings may lead to a correct diagnosis of early stage intestinal tuberculosis.
    Gastrointestinal Endoscopy 04/2004; 59(3):362-8. DOI:10.1016/S0016-5107(03)02716-0 · 5.37 Impact Factor
  • Gastrointestinal Endoscopy 04/2004; 59(3):393-5. DOI:10.1016/S0016-5107(03)02720-2 · 5.37 Impact Factor
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