Case report of a Nigerian with ileocecal tuberculosis which mimicked Crohn's disease at colonoscopy

Abstract

Both tuberculosis (TB) and Crohn's disease can affect any part of the gastrointestinal tract, but the terminal ileum and ileocecal region are mostly affected. Colonoscopic features of erythema, mucosal nodules, ulcers, strictures, and a deformed ileocecal valve occur in TB are nonspecific and can also occur in Crohn's disease. This is a case of a Nigerian with ileocecal TB, which mimicked Crohn's disease at colonoscopy. The patient is a 23-year-old man who presented to the clinic on account of recurrent abdominal pain and weight loss of 7 months duration. There was history of nonmucoid, nonbloody, and nonfoul smelling bowel motions. He had progressive weight loss was progressive with history of nausea, bloating, and anorexia but no vomiting. Colonoscopy revealed polypoid lesions in the cecum, deformed and polypoid ileocecal valve, and cobblestone appearance in the ileum. The histology of the ileal and colonic biopsies showed diffuse transmural infiltration by lymphocytic cells. Because of the extent of cecal and ileal involvement together with severe abdominal pain the patient was experiencing, he was taken for surgery where a right hemicolectomy with ileotransverse anastomosis was performed. The histology of the resected bowel then revealed features consistent with TB.