Intestinal Tuberculosis in Surgical Pathology - Experience from a Tertiary Care Hospital

Abstract

Background: Intestinal tuberculosis (ITB) represents the most common type of abdominal TB. Definitive diagnosis of intestinal tuberculosis is made on the basis of morphological examination of surgical specimens in majority of cases as clinico-radiological features are non-specific in initial stages of the disease. Aims: To analyze the surgical pathology data on intestinal tuberculosis of the hospital and to document findings of morphological examination. Setting: A descriptive study of intestinal tuberculous lesions encountered in surgical specimens received during a period of three years in the histopathology section of a tertiary care hospital. Materials and Methods: 40 cases of intestinal tuberculosis out of 250 consecutive, surgically excised specimens of small and large bowel were included in this study. One year retrospective and two years prospective data is included in the study. Results: Intestinal obstruction was the most frequent clinical presentation followed by perforation peritonitis in ITB cases in this series.9 patients had past history of pulmonary and/or intestinal tuberculosis. Out of 31patients without past history of TB, 25.80% were suspected of having TB preoperatively on the basis of clinical and imaging findings. Ileal and ileo-caecal region was most frequently involved. The three gross morphological forms of tuberculous enteritis seen were ulcerative in 82.5%, ulcero-hypertrophic in 15% and hypertrophic in 2.5 %cases. Characteristic caseating granulomas were seen in 60% cases. Conclusion: Changes in clinical presentation of Intestinal TB are being observed. High index of suspicion is needed at every step of diagnosis of intestinal TB as many non-tuberculous lesions share same clinical and radiological findings.