Diagnosis of Intestinal Tuberculosis at Viet Duc Hospital (2004-2009)
Keywords:
acute abdomen, colonoscopy, intestinal tuberculosis, PCR assayAbstract
Purpose: Gastrointestinal tuberculosis, especially complicated intestinal tuberculosis (ITB) is still anongoing challenge for physicians and radiologists. This study aimed to assess the clinical features and related
factors which might help the diagnosis and direct proper management.
Materials and Methods: This was a retrospective study of all ITB diagnosed in patients over 16 years
of age who were treated at Viet Duc Hospital from 2004 to 2009. ITB was confirmed by histopathological
examination or PCR assay of the biopsies or surgical specimens.
Results: There were 85 cases of ITB patients including 61 men and 24 women. Common symptoms were
abdominal pain (90%), diarrhea (82%), weight loss (61%) and fever (55%). A medical history of TB was found
in 41% of cases. The complications most commonly observed were bowel obstruction (38.8%) and peritonitis
(25.5%). Ultrasound and CT scan findings were ascites, ileo-cecal bowel wall thickening, proximal dilatation
of bowel loops and cecal mass. Colonoscopy with biopsy confirmed the diagnosis in 66.7% whereas PCR assay
was positive in 53.9%. A pre-operative diagnosis was established in 39% of patients, while the diagnosis was
established intra-operatively in 83.5%. There were surgical indications to make a diagnosis in 13.9%.
Conclusion: ITB has diverse and non-specific symptoms and is an ongoing diagnostic dilemma for both
physicians and radiologists. X-ray and endoscopy with biopsy are the most helpful means for establishing a
definitive diagnosis.
References
1. LaV”n Hoμnh. Intestinal tuberculosis. Tuberculosis and
pulmonary diseases. Medical publisher 1996;2:97-116.
2. Khan R, Abid S, Jafri W, Abbas Z, Hameed K, Ahmad Z.
Diagnostic dilemma of abdominal tuberculosis in non-HIV
patient: an ongoing challenge for physicians. World J
Gastroenterol 2006;39:6371-5.
3. Sharma MP, Bhatia V. Abdominal tuberculosis. Indian J
Med Res 2004;120:305-15.
4. Leung VSK, Law ST, Lam CW, Luk ISC, Chau TN, et al.
Intestinal tuberculosis in a regional hospital in Hong Kong : a
10-year experience. Hong Kong Med J 2006;4:246-71.
5. Quang V’n TrY. Diagnosis and treatment the intestinal
tuberculosis associated with lung tuberculosis. J Med Pharm
Inform (special on tuberculosis) 2007;257-63.
6. Brodie D, Schluger NW. The diagnosis of tuberculosis. Clin
Chest Med 2005;26:247-71.
7. Naval GR, Chua ML. Diagnosis of intestinal tuberculosis
among patients with chronic diarrhea: role of intubation
biopsy. Phil J Microbiol Infect Dis 1998;27:23-7.
8. Sahbazian B, Weis SE. Treatment of active tuberculosis:
challenges and prospects. Clin Chest Med 2005;26:273-82.
9. Akgun Y. Intestinal and peritoneal tuberculosis : changing
trends over 10 years and a review of 80 patients. Can J Surg
2005;2:131-6.
10. Afzal S, Qayum I, Ahmad I, Kundi S. Clinical diagnostic
criteria for suspected ileocaecal tuberculosis. J Ayub Med
Coll Abbottabad 2006;4:42-6.
11. Hablani N, Souei Mhiri M, Tlili Graies K, Jemni Gharbi H,
Abdallah S, et al. La tubeculose abdominale pseudotumorale
a propos de 4 observations. J de Radiologie
2005;9:1021-5.
12. Suri DABR, Gupta S, Suri R. Computed tomograpgy in
abdominal tuberculosis. Br J Radiol 1999;72:92-8.
13. Nguyen Duc C, Pham Hai B, Pham Van T, Ton That B, Huguier
M. Tuberculose compliquee du tube digestif. Annal de
Chirurgie 2006;131:306-10.
pulmonary diseases. Medical publisher 1996;2:97-116.
2. Khan R, Abid S, Jafri W, Abbas Z, Hameed K, Ahmad Z.
Diagnostic dilemma of abdominal tuberculosis in non-HIV
patient: an ongoing challenge for physicians. World J
Gastroenterol 2006;39:6371-5.
3. Sharma MP, Bhatia V. Abdominal tuberculosis. Indian J
Med Res 2004;120:305-15.
4. Leung VSK, Law ST, Lam CW, Luk ISC, Chau TN, et al.
Intestinal tuberculosis in a regional hospital in Hong Kong : a
10-year experience. Hong Kong Med J 2006;4:246-71.
5. Quang V’n TrY. Diagnosis and treatment the intestinal
tuberculosis associated with lung tuberculosis. J Med Pharm
Inform (special on tuberculosis) 2007;257-63.
6. Brodie D, Schluger NW. The diagnosis of tuberculosis. Clin
Chest Med 2005;26:247-71.
7. Naval GR, Chua ML. Diagnosis of intestinal tuberculosis
among patients with chronic diarrhea: role of intubation
biopsy. Phil J Microbiol Infect Dis 1998;27:23-7.
8. Sahbazian B, Weis SE. Treatment of active tuberculosis:
challenges and prospects. Clin Chest Med 2005;26:273-82.
9. Akgun Y. Intestinal and peritoneal tuberculosis : changing
trends over 10 years and a review of 80 patients. Can J Surg
2005;2:131-6.
10. Afzal S, Qayum I, Ahmad I, Kundi S. Clinical diagnostic
criteria for suspected ileocaecal tuberculosis. J Ayub Med
Coll Abbottabad 2006;4:42-6.
11. Hablani N, Souei Mhiri M, Tlili Graies K, Jemni Gharbi H,
Abdallah S, et al. La tubeculose abdominale pseudotumorale
a propos de 4 observations. J de Radiologie
2005;9:1021-5.
12. Suri DABR, Gupta S, Suri R. Computed tomograpgy in
abdominal tuberculosis. Br J Radiol 1999;72:92-8.
13. Nguyen Duc C, Pham Hai B, Pham Van T, Ton That B, Huguier
M. Tuberculose compliquee du tube digestif. Annal de
Chirurgie 2006;131:306-10.
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Published
2010-09-30
How to Cite
1.
Nguyen DC, Do DV, Do SH, Nguyen VX, Nguyen Q, Ninh VK, Pham HB, Huguier M. Diagnosis of Intestinal Tuberculosis at Viet Duc Hospital (2004-2009). Thai J Surg [Internet]. 2010 Sep. 30 [cited 2024 Nov. 23];31(3). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/227588
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