Cases Of Intestinal Tuberculosis Research Articles

Intestinal tuberculosis: findings on double-contrast barium enema.

Seven cases of intestinal tuberculosis in an active stage were studied by the double-contrast barium enema (DCBE) method. Formerly, diagnosis of intestinal tuberculosis in the early stage by single-contrast barium enema (SCBE) and barium meals was based on functional phenomena, such as spasm and hypermotility of the ileocecal region. Presently, this can be better accomplished by DCBE. DCBE enables the detection of shallow ulcers with their characteristic elevated margins. These ulcers are frequently slim and transversally oriented. Confluence of ulcers may create whole girdle ulcers or affect entire segments. In more advanced stages, characteristic deformities, also evident by SCBE, such as symmetrical annular stenoses, shortening, retraction, pouch formation, and the frequently observed pathology of the ileocecal valve and the cecal region, acquire a new dimension with DCBE.

The Fibercolonoscopic Diagnosis of Intestinal Tuberculosis

In Japan one can still find intestinal tuberculosis; we have experienced 9 cases of intestinal tuberculosis and 5 suspected cases. 13 cases of them were observed among 1071 cases of colonoscopy from June 1969 to May 1974 (5 years). When caseation of tubercle granuloma and bacilli are found, the diagnosis is easy. The endoscopic features of typical intestinal tuberculosis, ulcers of various sizes and shapes, were observed. The base of large ulcers showed granular appearance and unevenness, its margins were prominent ed-ematous and red in color, ileocecal area was destroyed. Although typical lesions of tuberculosis are found by colonoscopy and barium enema, it is difficult to get the typical granuloma with caseation. In case of suspected intestinal tuberculosis, it is better to use the antituberculous drugs; if the symptoms improve the diagnosis is sure, too.

Segmental tuberculosis of the colon with entero-colic fistula.

An isolated tuberculous lesion of the large bowel beyond the caecum is a rarity even in countries where tuberculosis of the intestinal tract is not uncommon. Chawla, Mukerjee and Bery (1971) report only ten cases of isolated lesions of the large bowel beyond the caecum in over 750 cases of tuberculous enterocolitis, and Bhansali (1968) reports three cases of isolated colonic involvement beyond the caecum in 87 cases of intestinal tuberculosis. The formation of internal fistulae in these cases is very rare. We are reporting a case of isolated segmental tuberculosis of the sigmoid colon complicated by entero-colic fistula in an Asian immigrant seen at the Coventry Group of Hospitals, where pre-operatively the diagnosis was mistaken for Crohn's disease.

Surgical complications of intestinal tuberculosis as seen at necropsy

I=ORTY-EIGHT CASES OF INTESTINAL TUBERCULOSIS There have been no reports in recent years on the incidence of puImonary tubercuIosis and its intestina1 compIications in genera1 hospitaIs. A review of 4,200 consecutive autopsy protocoIs at Morrisania City HospitaI from 1930 to 1946 reveaIed an incidence of 4.05 per cent (170 cases) of active puImonary tubercuIosis. In this group of 170 pthisic patients there was an incidence of intestina tubercuIosis of onIy 28.23 per cent (forty-eight cases). The sites of prediIection were the iIeum and cecum. (Table I.) Location of Lesions

Intestinal tuberculosis: Some observations

Summary Six cases of intestinal tuberculosis, occurring in association with moderately extensive pulmonary disease, are recorded. An account is given of their treatment with a low-residue, high-vitamin diet, calcium and ultra-violet light. It is suggested that this regime is of considerable value in such cases, but that the permanency of any result achieved is dependent upon effective control of the parent lesion in the lung.

Some Cases of Intestinal Tuberculosis in Phthisics, with Reference Especially to the Prognosis

Some Cases of Intestinal Tuberculosis in Phthisics, with Reference Especially to the Prognosis

Some Cases of Intestinal Tuberculosis in Phthisics, with Reference Especially to the Prognosis

Some Cases of Intestinal Tuberculosis in Phthisics, with Reference Especially to the Prognosis

Diagnosis of Intestinal Tuberculosis

Intestinal tuberculosis occurs as an ulcerative lesion complicating pulmonary tuberculosis, as a hypertrophic mass, and as a miliary form associated with tuberculous peritonitis. The ulcerative lesion is the most common of the three varieties and its diagnosis can be made with a high degree of accuracy. The chief method of diagnosis is roentgenological and its development has been due chiefly to the work of Pirie, Stierlin, Brown and Sampson. The taking of a careful history is of next importance. The clinician must be familiar with the natural history of the various dyspepsias to evaluate properly the symptoms present. Laboratory findings are usually of little aid in diagnosis. Ulcerative intestinal tuberculosis is always a complication of pulmonary tuberculosis and often shows an activity parallel to that of the parent lesion. However, it frequently runs an independent course and may cause severe symptoms or death after the pulmonary lesions have become inactive. A study of over 300 cases shows a similar incidence in males and females. All ages are represented and the older patients have an incidence similar to younger patients, but the older the enteritis the less distressing are the symptoms. At Hopemont Sanitarium, the autopsy incidence of enteritis is 70 per cent. Clinically, however, it occurs in 15 to 20 per cent of the sanatorium population, where a great majority show faradvanced disease in the lungs. In a tuberculosis sanatorium the non-tuberculous dyspepsias are about four times more frequent than those due to tuberculous enteritis. In this series, only 1 per cent of the cases occurred in association with minimal pulmonary disease; 9 per cent occurred with moderately advanced disease; and 90 per cent with faradvanced disease. The exudative pulmonary lesion was associated with 25 per cent of the enteritis cases, and the chronic form with the remaining 75 per cent. Pulmonary cavitation was present in 94 per cent of the cases at the time of onset of bowel symptoms; cavitation had been present in 4 per cent prior to the onset of symptoms; no cavity was found in 2 per cent of the cases whose diagnosis was made by laparotomy or autopsy. The sputum was positive for tubercle bacilli in 97 per cent at the time of onset of the symptoms. Intestinal tuberculosis may be present without symptoms. Ten per cent of the enteritis found at autopsy showed no digestive disturbances during life. Enteritis may be present long before symptoms appear and may be started clinically by a pulmonary spread, pleural effusion or an operation. The reason for such variability, we believe, is due mainly to a local neuromuscular irritability plus an afferent-parasympathetic efferent reflex to the involved segment. We feel that this neurogenic view best explains the clinical onset of enteritis, its severity, symptomatology, duration and response to treatment. The onset of symptoms was sudden in 67 per cent and gradual in 33 per cent. The rapid onset often dates back to some food or laxative or surgical intervention. Although collapse therapy benefits greatly about 40 per cent of all cases of intestinal tuberculosis, yet some cases date their onset to some form of collapse therapy and other cases show an aggravation of symptoms by these procedures. The symptoms of enteritis may be many or few, mild or severe, local or general. Systemic symptoms may include nervousness, insomnia, chills, fever and failure to gain weight. The digestive symptoms occur in the following order: Anorexia, 85 per cent; crampy pain, 80 per cent; nausea, 70 per cent; diarrhea, 65 per cent; flatulence, 50 per cent; vomiting, 45 per cent; epigastric distress or pain, 30 per cent; constipation, 20 per cent; pyrosis, 20 per cent; tender right lower quadrant, 10 per cent; acid regurgitation, 10 per cent; constipation alternating with diarrhea, 10 per cent; gross blood in stool, 6 per cent; appendicitis, 4 per cent; allergic phenomena in 2 per cent. Diarrhea and pain occur in two-thirds of all cases and should one wait for these symptoms to appear many early cases will be missed. In this group we include also the cases