Response of tuberculous stricture to antituberculous treatment.

Anand, B S; Nanda, R.; Sachdev, G K

doi:10.1136/gut.29.1.62

Cited by 94 publications

(58 citation statements)

References 13 publications

(1 reference statement)

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“…At the end of one year, 91 percent showed clinical improvement. (38) The high incidence of non-response to ATT and surgical resection in our study could have been because of large polypoidal lesions in these patients, and they presented with intestinal obstruction.…”

Section: Discussionmentioning

confidence: 71%

Clinical and Colonoscopic Profile of Isolated Colonic Tuberculosis at a Tertiary Care Hospital in North India

Chandail¹,

Jamwal²

2016

jemds

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BACKGROUNDTuberculosis (TB) is one of the oldest diseases known to affect humans and a major cause of death worldwide. According to World Health Organization, incidence of TB is approximately 9.4 million cases per year, of which 1.98 million cases are from India and close to 500,000 per year die of the disease in India. It has been estimated that 2-3% of patients with abdominal TB have isolated colonic involvement. The diagnosis of intestinal TB is a challenge for physicians due to its diverse clinical manifestations that mimic other infectious diseases, autoimmune, and neoplastic disorders and therefore, a high index of suspicion is essential to reach the correct diagnosis. MATERIALS AND METHODSThis was a retrospective analysis of colonoscopic findings of patients with isolated colonic tuberculosis who presented between April 2015 -July 2016. All the patients above 18 years of age with suspected diagnosis of intestinal tuberculosis were included in the study. Patients with ulcerative colitis, Crohn's disease, microscopic colitis and indeterminate colitis or carcinoma colon, HIV positive patients were excluded from the study. These patients were taken up for colonoscopy and distal ileoscopy after proper preparation. The findings observed in any part of the colon with particular reference of any aphthous ulcers, granularity, deep ulcers, nodules, polypoidal lesions and luminal narrowings were recorded. A confirmed diagnosis of isolated colonic tuberculosis was made when there were caseating granulomas and or acid fast bacilli on biopsy samples. A suspected diagnosis was made when there was clinical suspicion, with family history of colonic tuberculosis, biopsy showing noncaseating granulomas with chronic inflammation and response to antitubercular therapy. Those patients who had confirmed or suspected diagnosis of isolated colonic tuberculosis were started on antitubercular therapy for a period of 6 months. RESULTSThe data of a total of 43 patients was retrieved from the records for this study. Out of these 43 patients, 6 patients were lost to followup. A total of 3 patients did not respond to the antitubercular treatment and were subsequently diagnosed as Crohn's disease on further evaluation. Finally, a total of 34 patients were evaluated in this study, out of which 22 were males and 12 were females. The minimum age in all these patients was 18 years with a maximum age of 79 years. The most common symptom of presentation was pain abdomen (91.17%) followed by anorexia (88.23%), Fever (73.52%), weight loss (70.58%), chronic diarrhoea (52.94%), constipation (26.47%) patients, mass abdomen (20.58%) and bleeding per rectum (14.70%) of patients. The colonoscopic findings were aphthous ulcers in 18 (52.94%), deep ulcers in 16 (47.05%), nodules in 19 (55.88%), luminal narrowing in 8 (23.52%) and polypoidal lesions in 5 (14.70%) of patients. The commonest site involved in our patients with isolated colonic tuberculosis was ileocecal valve with caecum in 29 (84.29%) of patients, followed by isolated ascending co...

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Section: Discussionmentioning

confidence: 71%

Clinical and Colonoscopic Profile of Isolated Colonic Tuberculosis at a Tertiary Care Hospital in North India

Chandail¹,

Jamwal²

2016

jemds

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“…Na maioria dos doentes deste trabalho, a terapêutica específica foi mantida por doze meses, como indicado na época. Mesmo pacientes com sub-estenoses apresentam resposta favorá-vel ao tratamento clínico 14 . Nas formas intestinais isoladas obstrutivas ou quando da impossibilidade diag-nóstica, está indicada a cirurgia, como realizado nos doentes deste estudo.…”

Section: Resultsunclassified

Tuberculose ileocecal isolada simulando neoplasia maligna e doença de Crohn

Bromberg¹,

Faroud²,

Castro³

et al. 2001

Rev. Assoc. Med. Bras.

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INTRODUÇÃONos últimos anos, a tuberculose intestinal voltou a preocupar seus estudiosos por apresentar expressiva recrudescência. Países desenvolvidos constatam-na em número expressivo de imigrantes oriundos de nações, onde a tuberculose é prevalente, mas vêem também seus doentes imunodeprimidos assolados pela doença. No Brasil, a tuberculose intestinal está, geralmente, associada à presença de lesões pulmonares, ativas ou cicatrizadas, ao passo que em áreas não prevalentes, o número de lesões intestinais . Nesta eventualidade, a tuberculose intestinal freqüentemente é confundida com outras afecções, como as neoplasias e a doença de Crohn, o que dificulta, em muito, a terapêutica a ser instituída [2][3][4]

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“…Only 3 cases (8%) needed surgery. 11 We did not suspect the diagnosis of abdominal tuberculosis breakthrough before surgery, because the patient was on antituberculosis therapy. Exploratory laparotomy was indicated because of the suspicion of mechanical bowel obstruction.…”

Section: Discussionmentioning

confidence: 99%