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Colonic tuberculosis: Clinical features, endoscopic appearance and management
Author(s) -
Misra Sri Prakash,
Misra Vatsala,
Dwivedi Manisha,
Gupta Suresh
Publication year - 1999
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1046/j.1440-1746.1999.01940.x
Subject(s) - medicine , tuberculosis , colonoscopy , asymptomatic , epithelioid cell , abdominal pain , biopsy , gastroenterology , pathology , colorectal cancer , cancer , immunohistochemistry
Background : Although rare in the West, colonic tuberculosis is not an uncommon disease in developing countries. However, the clinical manifestations and radiological appearance of the disease are non‐specific. In recent years, colonoscopy has been found to be very useful in diagnosing patients with colonic tuberculosis. Methods : Clinical features, colonoscopic findings, histology and response to treatment were recorded in 50 patients with colonic tuberculosis. Results : Abdominal pain, fever, anorexia, weight loss and diarrhoea were the common symptoms. The colonoscopic features consisted of ulcers (92%), nodules (88%), deformed caecum and ileocecal valve (42%), strictures (25%), multiple fibrous bands (8%) and polypoid lesions (6%). Segmental tuberculosis and lesions simulating carcinoma were seen in 22 and 16% of patients, respectively. Histological examination of the colonic biopsy specimens showed well‐formed, non‐caseating granulomas in 18%, collection of loosely arranged epithelioid cells in 40% and chronic non‐specific inflammatory changes in 42% of the patients. Six patients needed surgical intervention. The other 44 patients responded well to anti‐tuberculous therapy and became asymptomatic. Conclusions : It is concluded that colonoscopy is a useful method for diagnosing colonic tuberculosis. It is suggested that if the clinical picture and colonoscopic appearance are suggestive of tuberculosis and target biopsies reveal non‐caseating granulomas, a collection of loosely arranged epithelioid cells, or even non‐specific changes, then a therapeutic trial of anti‐tuberculous drugs should be given and continued if there is clinical improvement.