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PubMedDate not supplied

[Gastrointestinal and peritoneal tuberculosis].

One hundred and forty cases of gastrointestinal and/or peritoneal tuberculosis seen in 18 years at Cayetano Heredia National Hospital in Lima, Perú, are reported. The intestinal localization was 48.5%, peritoneal 33% and both 18.5%. These cases represented 4.5% of all patients diagnosed as tuberculosis. The most frequent age group was between 14 and 24 years, male/female ratio: 1/1.2 and the majority came from poor areas of the country. The most frequent symptoms were weight loss, abdominal pain and diarrhoea. Anemia and hypoalbuminemia were frequent. Eighty five percent had extra-abdominal tuberculosis. The most frequent complication was intestinal obstruction. The mortality in this study was 14.5%.

Adolescent↗
PubMed1996

Massive rectal bleeding from colonic tuberculosis.

We describe a patient with massive rectal bleeding from colonic tuberculosis. This is an uncommon presentation of gastrointestinal tuberculosis with fewer than 20 cases reported in the medical literature. The incidence of tuberculosis has been increasing during the last decade. The resurgence of tuberculosis (secondary to increased immigration, more patients on immunosuppressive therapy, and the AIDS epidemic) mandates that the clinician be aware of the wide spectrum of presentation of intestinal tuberculosis. Endoscopy is the preferred method used to diagnose colonic tuberculosis.

Acute Disease↗
PubMed2004

HIV infection presenting with duodenal tuberculosis.

Extrapulmonary tuberculosis is a protean and often difficult to recognise infection. Gastrointestinal tuberculosis is a rare condition that mainly occurs in immunodeficient people. We report a case of duodenal tuberculosis, which presented with gastrointestinal symptoms, anaemia and hyponatraemia, in a patient with previously undiagnosed HIV infection.

AIDS-Related Opportunistic Infections↗
PubMed1994

Sonographic findings in gastrointestinal and peritoneal tuberculosis.

The various ultrasound (US) findings in 90 patients with abdominal (gastrointestinal, peritoneal, mesenteric and lymph node) tuberculosis (TB) studied in an area of high incidence of TB over a 1 year period were analysed. The lesions encountered were intestinal (n = 31), extraintestinal (n = 39), or a combination (n = 20). The extraintestinal lesions included free and loculated ascites (n = 36), localized ascites ('Club Sandwich sign') (n = 4), adhesions (n = 14), peritoneal thickening (n = 14), peritoneal nodules (n = 3), lymphadenopathy (n = 23) and cold abscesses (n = 10)-of these, the presence of fine fibrinous strands in the ascetic fluid, localized ascites and caseous or calcified lymph nodes were highly suspicious of a diagnosis of TB in appropriate clinical settings. The bowel lesions were characterized by concentric bowel wall thickening (n = 31) with ulceration in six. Bowel thickening, when present in the ileocaecal junction and especially when situated in the subhepatic position, was suggestive of a tuberculous etiology. Complex masses in the abdomen pointed to an advanced stage of the disease. US is a useful imaging modality in patients clinically suspected of having abdominal TB for diagnosis and follow-up, although in a few cases differentiation of it from metastatic disease is difficult. When bowel involvement is suspected, barium studies should be performed.

Abscess↗
PubMed1994

Abdominal tuberculosis in children.

Four boys with abdominal tuberculosis, one of whom had acquired immunodeficiency syndrome, are presented. Abdominal imaging findings on plain radiography, ultrasonography, computed tomography, and gastrointestinal contrast studies included tuberculous peritonitis and ascites in all patients, tuberculous adenopathy in two, gastrointestinal tuberculosis in two, and omental tuberculosis in two. The radiographic features particularly characteristic of abdominal tuberculosis were: (1) low attenuating adenopathy with rim enhancement, (2) omental or ileocecal inflammatory mass, (3) high density ascites, and (4) gastrointestinal enteritis involving the ileocecal region. All patients had acid-fast bacilli identified in cultures of bodily fluids and/or pathologic specimens and three patients had cultures positive for Mycobacterium tuberculosis. The patient with a negative culture had a positive PPD skin test and a surgical specimen showing caseating granulomata and acid-fast bacilli in the omentum. The radiologist must maintain a high degree of suspicion for abdominal tuberculosis particularly in normal or immunosuppressed children with acquired immunodeficiency syndrome. Fine needle aspiration and biopsy of abdominal adenopathy, inflammatory mass or ascites may be necessary for diagnosis.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Tuberculosis of the distal colon. A case report.

A case of tuberculosis of the distal colon is described. The presenting features and the sites of the lesions are unusual even in a country where gastrointestinal tuberculosis is common. Attention is drawn to the diagnostic difficulty encountered, as the lesion is often clinically and radiologically indistinguishable from amoebiasis, carcinoma or Crohn's disease.

Adult↗
PubMedDate not supplied

[Peritoneal and intestinal tuberculosis: an ancestral disease that poses new challenges in the technological era. Case report and review of the literature].

UNLABELLED: Tuberculosis is a public health problem. The most common presentation is pulmonary disease. The diagnosis of any extrapulmonary forms are quite difficult. Clinical manifestations of gastrointestinal tuberculosis are non-specific and compatible with pathologies such as inflammatory bowel disease, advanced ovarian cancer, deep mycosis, yersinia infection and amebomas. Abdominal form is located at 6th place of the extrapulmonary forms, after lymphatic, genitourinary, osteoarticular, miliary and meningeal infections. Eventually, 25 to 75% of patients with abdominal tuberculosis will require surgery. These procedures should be limitated with the purpose to preserve small bowel. Resection should be limitated for complicated cases. The surgical indications include: Intestinal occlusion (15-60%), perforation (1-15%), abscesses and fistulas (2-30%) and hemorrhage (2%). CONCLUSIONS: In most of the cases, the diagnosis of peritoneal or intestinal tuberculosis is made during a laparoscopy or laparotomy even during surgery performed by different purposes. Excessive manipulation of the intraabdominal organs may produced unexpected bowel lesions, increasing morbidity and mortality. Medical treatment is highly effective in the resolution of moderate complications such as bowel obstruction. Resectional procedures should be reserved for complications like perforation, bleeding or stenosis non-suitable for stricturoplasty.

Adult↗