Intestinal tuberculosis and Crohn�s disease: the importance and difficulty of a differential diagnosis

Gallego, Esther Merino; Sánchez, Fernando Sánchez; Rojo, Francisco Javier Gallego

doi:10.17235/reed.2018.5184/2017

Cited by 18 publications

(12 citation statements)

References 48 publications

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“…Therefore, diagnosing abdominal TB may be challenging due to its nonspecific findings 3 . Precise diagnosis is vital, as different treatment approaches depend on the diagnosis 4,5 …”

Section: Introductionmentioning

confidence: 99%

Current role of endoscopic ultrasound for gastrointestinal and abdominal tuberculosis

et al. 2022

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A high incidence of tuberculosis (TB), especially in endemic countries, makes this infectious disease a concern. Abdominal TB contributes to 10% of extrapulmonary TB. Due to nonspecific clinical, radiological, and endoscopic findings, diagnosing abdominal TB continues to be a challenge. Hence, a precise diagnosis is needed. The diagnosis of gastrointestinal disease using endoscopic ultrasound (EUS) is often performed due to its high resolution and ability to provide a real-time visual representation of the gastrointestinal tract and extramural structures. EUS-guided fine-needle aspiration (FNA) and fineneedle biopsy (FNB) have helped diagnose TB as they offer an adequate specimen for cytology or histopathological examination. This method is considered safer, more effective, and more efficient. The capacity of EUS to diagnose abdominal TB based on the affected organs was examined via a literature search. We reviewed the role of EUS in diagnosing esophageal, gastric, pancreatic, peripancreatic, hepatosplenic, peritoneal, and intestinal TB. Generally, EUS aids in diagnosing abdominal TB. In some organs, it is superior to other diagnostic modalities. However, further examinations, such as cytology or histopathology and microbial, are still needed. We also studied the roles of EUS-FNA and EUS-FNB. EUS-FNA has shown a high diagnostic yield in esophageal (94.3-100%), pancreatic and peripancreatic (76.2%), and intestinal TB (84.1%). As minimally invasive methods, EUS-FNA and EUS-FNB can successfully provide sufficient samples. EUS is a functional diagnostic modality for abdominal TB. EUS-FNA and EUS-FNB provide sufficient samples safely and efficiently for further cytology, histopathology, and microbial examinations. Esophageal tuberculosisEsophageal TB is uncommon and has nonspecific clinical, laboratory, radiological, and endoscopic features. With prevalence

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“…Therefore, diagnosing abdominal TB may be challenging due to its nonspecific findings 3 . Precise diagnosis is vital, as different treatment approaches depend on the diagnosis 4,5 …”

Section: Introductionmentioning

confidence: 99%

Current role of endoscopic ultrasound for gastrointestinal and abdominal tuberculosis

et al. 2022

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“…The commonest sites of abdominal TB are the gastrointestinal tract/65–78%/, peritoneum and mesenteric lymph nodes. 3 , 6 , 10–13 …”

Section: Introductionmentioning

confidence: 99%

“…More than 70% of the cases are younger than 40 years. 3 , 6 , 7 , 10 , 12 , 14 , 15 The Gastrointestinal involvement has declined to 25% after the advent of anti –TB treatment. 16 Gastrointestinal TB can occur anywhere from the mouth to the anus.…”

Section: Introductionmentioning

confidence: 99%

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A Rare Case of Intestinal Tuberculosis with Chronic Partial Small Bowel Obstruction in a 37-Year-Old Ethiopian Man

Aregawi¹,

Alem²,

Girma³

2022

IMCRJ

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Tuberculosis (TB) is a chronic granulomatous inflammatory disease that affects any part of our body. TB is a significant problem in developing countries. Intestinal TB accounts for 2% of TB cases worldwide. Terminal ileum and cecum are the two commonly affected regions because of abundant lymphoid tissue, physiologic stasis, limited digestive activity and increased fluid and electrolyte absorption rate. Intestinal obstruction is the leading complication of intestinal TB, and it occurs because of intestinal luminal narrowing, multiple strictures or adhesions. The clinical presentation of patients with intestinal TB and post-TB intestinal obstruction is non-specific. It can be acute, chronic, or acute on chronic. Uncomplicated cases of intestinal TB can be managed medically. Surgery is reserved for complicated cases of intestinal TB, which includes peritonitis, intestinal obstruction and perforations. Here, we present a 37-year-old man who presented with long-standing, intermittent crampy abdominal pain and vomiting. He was diagnosed with chronic partial small bowel obstruction secondary to possibly small bowel carcinoma. We did segmental ileal resection and end-to-end ileo-ileal anastomosis. Postoperatively, the histopathology result turned out to be intestinal TB. This case report aims to make physicians aware of the rare condition of small bowel obstruction secondary to intestinal TB. Clinicians need to have a high index of suspicion in any patient with long-standing symptoms of partial obstruction and consider surgery and anti-TB once diagnosed.

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“…Differing sensitivity and specificity of diagnostic methods can lead to combining methods, repeated biopsies, and in some cases, laparoscopy. In cases of high clinical suspicion, although the bacillus cannot be detected, treatment may be initiated [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

A Never-Ending Challenge: Intestinal Tuberculosis or Inflammatory Bowel Disease

Yavuz¹,

Yıldırım²,

Akan³

et al. 2021

Cureus

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Intestinal tuberculosis is an uncommon form of tuberculosis, and its diagnosis remains a challenge in patients with Crohn's disease. The clinical, endoscopic, radiologic, and histologic features of Crohn's disease and tuberculosis are remarkably similar, posing a diagnostic challenge. Accurate diagnosis of these two conditions remains vital to the decision on the treatment of the patients. Computerized tomography, endoscopic ultrasound (EUS), capsule endoscopy, balloon enteroscopy, ascitic fluid adenosine deaminase (ADA), tuberculosis polymerase chain reaction (TB-PCR), GeneXpert MTB/RIF assay (Cepheid, Sunnyvale, CA), and laparoscopy can be beneficial in the diagnosis of intestinal tuberculosis. Herein, we report a case where tuberculosis could not be documented, although the patient displayed lymphocytosis in ascites and weight loss. Laparoscopy was diagnostic and the patient benefited from the correct treatment.

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Intestinal tuberculosis and Crohn�s disease: the importance and difficulty of a differential diagnosis

Cited by 18 publications

References 48 publications

Current role of endoscopic ultrasound for gastrointestinal and abdominal tuberculosis

Current role of endoscopic ultrasound for gastrointestinal and abdominal tuberculosis

A Rare Case of Intestinal Tuberculosis with Chronic Partial Small Bowel Obstruction in a 37-Year-Old Ethiopian Man

A Never-Ending Challenge: Intestinal Tuberculosis or Inflammatory Bowel Disease

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