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Abstract

Tubercle bacillus was discovered in 1882 by Robert Koch. With the introduction of chemotherapy for tuberculosis in the 1940s the incidence of this entity decreased. The incidence of the tuberculosis of the colon began to increase at the 1980s with the rise in numbers of patients considered as high risk for this entity, such as HIV-infected individuals, patients with chronic renal disease, and immunosuppressed patients with prolonged steroid therapy. We report on two patients with history of chronic abdominal pain and weight loss with a palpable mass in the right lower quadrant. In one patient chest radiography revealed a miliary reticulonodular pattern. In both, abdominal CT scan showed retroperitoneal lymphadenopathy and colonic wall thickness. Colonoscopic examination showed ulcerative lesions and ileocecal valve disruption. Microscopic examination of intestinal content showed evidenced M. tuberculosis. Tuberculosis of the colon should be suspected in patients suffering from chronic abdominal pain and weight loss.

Colon Tuberculosis: Endoscopic Features and Prospective Endoscopic Follow-Up After Anti-Tuberculosis Treatment

“…In the series by Misra et al 35 10% of patients required surgery for massive lower gastrointestinal bleeding. Similar to previously published series, 11, 21, 35 in our study, the predominant lesions identified on colonoscopy were ulceration and nodularity. The right colon (ileocecal valve, cecum, and ascending colon) was significantly more affected compared with the left.…”

“…Similar to previously reported case series, 11, 21, 35, 39 majority of the patients had non-specific symptoms, with weight loss and abdominal pain being the predominant symptoms in over 80% of the patients. Less than half of the patients in this study had fever.…”

“…Case reports and small retrospective case series have been published describing the endoscopic features of TB of the colon. 11, 12, 13, 14, 15, 16, 17, 18, 20, 21, 31, 32, 33, 34, 35, 36, 37, 38 These features can be non-specific and mimic inflammatory bowel disease or malignancy. As follow-up colonoscopy is not routinely performed after completion of anti-TB treatment, there are limited data on predicting the outcomes of TB lesions, namely, resolution of, lack thereof, or scarring or stricturing of the lumen after healing.…”

“…Besides the terminal ileum, several small case series have described TB affecting the colon. 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21 TB of the colon is rare and hence it can be misdiagnosed as colon cancer, inflammatory bowel diseases, ischemic colitis or infectious colitis (also endemic in areas with high prevalence of TB).…”

A Case of Gastric Tuberculosis Mimicking Advanced Gastric Cancer

“…In the 1980s, however, the incidence of extrapulmonary tuberculosis began to increase even in developed countries, with a rise in the numbers of patients considered to be high risk for this disease. This high risk group includes HIV-infected individuals, immigrants from endemic areas, and immunosuppressed patients with transplantations, or who are undergoing prolonged steroid therapy5, 6). Other groups at high risk include alcohol abusers, injection drug users, elderly persons, and diabetic patients7).…”