Arteriographic manifestations of tuberculosis of the splenic flexure and the stomach.

Abstract

Tuberculosis of the colon distal to the ileo-caecal valve is an extremely rare disease (Bentley and Webster, 1967). Only sporadic cases of colonic tuberculosis beyond the ileocaecal valve have been reported in English literature. This is especially true in the United States of America (Gefel, Pruzanski, Altman and Lorant, 1963). Most often, this form of tuberculosis is segmental in type (Angelchik, Thabit and Mall, 1962). Gastro-intestinal tuberculosis of various sites is still a common occurrence in India. Bhansali (1968) reports 45 cases of colonic tuberculosis; of these, only three were beyond the ileo-caecal valve. Tuberculosis of the colon is often secondary to primary focus in the lung. The infected sputum along with the saliva is swallowed, gets diluted in the gastric acid and the viable tubercle bacilli get lodged into the lymph follicles of the terminal ileum. However, haematogeneous spread from the lung has also been described and this is probably responsible for the isolated segmental area of tuberculosis of the distal colon (Regio, 1961). Gastro-intestinal tuberculosis is either ulcerative or hyperplastic in type. The ulcerative form is predominantly secondary to the pulmonary infection, while hyperplastic form occurs in absence of pulmonary tuberculosis (Paustian and Bockus, 1959). No definite clinical picture has been attributed to the colonic tuberculosis and the symptoms are usually non-specific, resulting either from tuberculous stenosis, ulceration or generalized inflammatory process.