Presentation
The pain, when present, is usually greatest in the right lower abdominal quadrant. On palpation, tenderness about McBurney's point is often found, although the pain may be more generally distributed. A tumefaction is occasionally present. [pubs.rsna.org]
There are not much cases of eosinophilic enteritis presenting with intestinal obstruction reported in the literature and hence we are presenting this case report. References 1. Klein NC, Hargrove RL, Sleisenger MH, Jeffries GH. [ijhas.in]
Abstract Intestinal tuberculosis (TB) has a spectrum of clinical presentations. A 7-year-old male child presented with abdominal distension and pain, vomiting, and constipation for a week. [jpss.eu]
Abstract Three cases of ileocecal tuberculosis are presented with a review of pathogenesis, diagnosis and therapy. [ncbi.nlm.nih.gov]
Entire Body System
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Fever
Presentation low grade fever associated with loss of appetite and weight loss Patient Data Age: 30 Gender: Female 5 case questions available Loading images... [radiopaedia.org]
There had been a history of infrequent episodes of pain abdomen and mild fever for more than a month for which he remained under treatment of the medical department of the same hospital. [jpss.eu]
Case Report: Ileocecal Tuberculosis Abstract A 25 year-old female recent immigrant from Southeast Asia is admitted to hospital with chronic cough and fever with a new onset of bloody diarrhea. [ojs.library.ubc.ca]
Likely cause is Exam: AIIMS Pre PG - May - 2010 A pt presents with acute rheumatic carditis with fever. [quespedia.com]
No fever, chills, nor night sweats were reported. Colonoscopy revealed an ulcer with exudate at the ileocecal valve. Moreover, a circumferential, friable, nodular mass partially obstructing the lumen was noted 6 to 10 cm from the anal verge. [oncologypro.esmo.org]
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Weight Loss
Presentation low grade fever associated with loss of appetite and weight loss Patient Data Age: 30 Gender: Female 5 case questions available Loading images... [radiopaedia.org]
Case Report Mr B.S was a 23-year-old man who presented to the clinic on account of recurrent abdominal pain and weight loss of 7 months duration. [jmedtropics.org]
• General symptoms like: weight loss, malaise, evening rise of temperature, etc. • Alternating constipation and diarrhea • Mass in the right iliac fossa • Features of distal small bowel obstruction - abdominal pain, distension and vomiting. Q 3. [7med-pdf.com]
Here, we report a 66-year-old Filipino male who initially presented with a two-year history of altered bowel habits which eventually progressed to include haematochezia, decreased stool caliber, and constitutional symptoms of unquantified weight loss [oncologypro.esmo.org]
Patients infected with Mycobacterium Tuberculosis(Mtb) may present with ileocecal infection, weight loss and bleeding per rectum. [journals.lww.com]
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Swollen Knee
Exam: AIIMS Pre PG - May - 2010 A young man back from leisure tri has swollen knee joints & foreign body sensation in eyes. Likely cause is Exam: AIIMS Pre PG - May - 2010 A pt presents with acute rheumatic carditis with fever. [quespedia.com]
Respiratoric
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Orthopnea
He had history of nonproductive cough, but no drenching night sweat, orthopnea, or paroxysmal nocturnal dyspnea. He was not a known hypertensive, diabetic, or asthmatic. He neither drank alcohol nor smoked cigarette. [jmedtropics.org]
Gastrointestinal
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Abdominal Pain
Case Report Mr B.S was a 23-year-old man who presented to the clinic on account of recurrent abdominal pain and weight loss of 7 months duration. [jmedtropics.org]
Ileocecal TB usually presents with abdominal pain and occasionally with sub acute intestinal obstruction. [jpss.eu]
She was admitted in other hospitals and was brought to us two weeks ago with abdominal pain. Investigations revealed a right sided abdominal mass. She was too sick to be operated upon straightaway since her blood pressure was barely recordable. [manalihospital.com]
Even in the clear-cut cases, abdominal pain is of varying constancy and intensity. [pubs.rsna.org]
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Chronic Abdominal Pain
abdominal pain, fever and malabsorption. [journals.lww.com]
Ileocecal tuberculosis is one of the most important differential diagnoses for chronic abdominal pain in the rural population. [ispub.com]
abdominal pain, chronic diarrhea, weight loss, or growth failure) plus either extraintestinal manifestations (fever, arthritis or arthralgia, pyoderma gangrenosum, perianal disease, or primary sclerosing cholangitis), inflammatory markers (iron deficiency [jdeonline.in]
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Tenderness at McBurney's Point
On palpation, tenderness about McBurney's point is often found, although the pain may be more generally distributed. A tumefaction is occasionally present. [pubs.rsna.org]
Liver, Gall & Pancreas
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Asterixis
There were no focal neurological deficits and asterixis. The full blood count showed a packed cell volume of 25% and white blood cell and platelets count were normal. The chest X-ray was also normal. [jmedtropics.org]
Neurologic
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Focal Neurologic Deficit
There were no focal neurological deficits and asterixis. The full blood count showed a packed cell volume of 25% and white blood cell and platelets count were normal. The chest X-ray was also normal. [jmedtropics.org]
Workup
Here, we report a case of isolated colonic tuberculosis where the initial diagnostic workup was suggestive of Crohn's disease. [gastrointestinalatlas.com]
Results Of the total study subjects, 266 patients were chosen for diagnostic laparoscopy based on the fact that their findings and symptomatology were so vague that a conclusion could not be drawn from the clinical examination and the usual laboratory workup [intechopen.com]
Endoscopy The most common site of involvement for both ITB and CD diseases is the ileocolonic region, and hence ileocolonoscopy is crucial for the diagnostic workup of both diseases. [ijri.org]
X-Ray
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Colonic Stricture
Ileocaecoplasty and coloplasty are also advocated for ileocaecal and colonic strictures, respectively. [ots1.narod.ru]
Microbiology
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Trichinella Spiralis
1999: IgG, IgG1 and IgM response in Trichinella spiralis-infected mice treated with 4-deoxypirydoxine or fed a Vitamin B6-deficient diet de Haas, M., 2001: IgG-Fc receptors and the clinical relevance of their polymorphisms Richard, C.A.; Wilcox, B.D [eurekamag.com]
Colonoscopy
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Colitis
Our study shows non-caseating granuloma is not significant to the differential diagnosis of tuberculous colitis from Crohn’s colitis. [wjgnet.com]
Diffuse ulcerating colitis pseudopolyps c. Amputated/ coned/ contracted caecum III) Gastroduodenal: a. Simultaneous involvement of pylorus duodenum à 'linitus plastic' appearance. b. [gradestack.com]
Eosinophilic colitis due to rifampicin. Lancet 1994;344:1296-7. [ PUBMED ] 4. Alfadda AA, Storr MA, Shaffer EA. Eosinophilic colitis: Epidemiology, clinical features, and current management. Therap Adv Gastroenterol 2011;4:301-9. 5. [ijhas.in]
Ileocecal Tuberculosis, Including a Comparison of This Disease with Non-specific Regional Entero Colitis and Noncaseous Tuberculated Enterocolitis, Int. Abst. Surg., 91, 417, 1950. Google Scholar 6. Bargen, J. [link.springer.com]
The fiber colonoscopy diagnosis of tuberculous colitis. Endoscopy 1975;7:113-21. 9. D'Haens G, Rutgeerts P. Endoscopic evaluation. In: Prantera C, Korelitz B, editors. Crohn's Disease. 1 st ed. New York: Marcel Dekker, Inc.; 1996. p. 113-23. 10. [jmedtropics.org]
Treatment
[…] of anti-tuberculosis treatment ( P 0.01, Table 3 ). [wjgnet.com]
Differentiation from Crohn's disease is a major diagnostic problem on which rational treatment depends. An angiographic appearance demonstrated in two patients is believed to be a useful diagnostic indicator of tuberculous etiology. [ncbi.nlm.nih.gov]
Differentiation between ileocecal tuberculosis and eosinophilic enteritis becomes more so important in cases not presenting with complete intestinal obstruction in whom conservative treatment would be planned; as the treatment option is entirely different [ijhas.in]
There had been a history of infrequent episodes of pain abdomen and mild fever for more than a month for which he remained under treatment of the medical department of the same hospital. [jpss.eu]
SHOW SIDEMENU Date 24 November 2018 Event ESMO Asia 2018 Congress Session Poster display - Cocktail Topics Colon and Rectal Cancer Cancer Treatment in Patients with Comorbidities Presenter Jan Michael Jesse Lomanta Authors J.M.J.C. Lomanta 1, C.D.V. [oncologypro.esmo.org]
Prognosis
Crohn's disease – Occurrence, course and prognosis. An epidemiologic cohort-study. Dan Med Bull 1997;44:287-302. 2. Scotiniotis I, Rubesin SE, Ginsberg GG. Imaging modalities in inflammatory bowel disease. [jmedtropics.org]
PROGNOSIS The prognosis of uncomplicated abdominal tuberculosis is good. Most patients who undergo effective surgical management of complications respond well. [ots1.narod.ru]
[…] disease), perforation Obliteration of ileocecal angle with widely patent ileocecal valve Rapid emptying of inflamed terminal ileum (Stierlin sign) Often associated mesenteric lymphadenopathy with increased mesenteric thickness Prognostic factors Worse prognosis [pathologyoutlines.com]
Surgery is the mainstay of treatment and, when done with adequate preparations, has good prognosis. Ileocecal tuberculosis is one of the most important differential diagnoses for chronic abdominal pain in the rural population. [ispub.com]
Though intussusception carries a very good prognosis, decisive prognostic factor is the nature of pathology leading to process. [10] To conclude, adult ileocolic intussusception due to tuberculosis should be kept in mind in patients presenting with chronic [atmph.org]
Etiology
An angiographic appearance demonstrated in two patients is believed to be a useful diagnostic indicator of tuberculous etiology. [ncbi.nlm.nih.gov]
Certain observations as to the etiology are noted and since the process was reversed by bowel resection, it is assumed that the intestinal tuberculosis was responsible for the so-called target cell anemia. [link.springer.com]
Although 90% of cases of pediatric intussusceptions are idiopathic, a demonstrable etiology is found in 70-90% of adult cases. [1] Adult patients with ileococlic intussusceptions have underlying neoplasm either benign or malignant as an etiological factor [atmph.org]
Eosinophilic enteritis is a rare cause of intestinal obstruction with varied etiology which can mimic ileocecal tuberculosis. [ijhas.in]
Pathogen host: predominantly humans Mycobacterium bovis : Common pathogen causing gastrointestinal tuberculosis Mechanism of infection: predominantly via ingestion of contaminated cow's milk Pathogen reservoir: predominantly cattle References: [4] [5] Etiology [amboss.com]
Epidemiology
Eosinophilic colitis: Epidemiology, clinical features, and current management. Therap Adv Gastroenterol 2011;4:301-9. 5. Copeland B, Aramide OO, Wehbe SA, Fitzgerald SM, Krishnaswamy G. [ijhas.in]
An epidemiologic cohort-study. Dan Med Bull 1997;44:287-302. 2. Scotiniotis I, Rubesin SE, Ginsberg GG. Imaging modalities in inflammatory bowel disease. Gastroenterol Clin North Am 1999;28:391-421. 3. [jmedtropics.org]
Epidemiology Sex : (2:1) United States Globally The incidence of multidrug-resistant tuberculosis is steadily rising. References: [1] [2] [3] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
[…] necessary for multidrug resistant and extensively drug resistant TB Surgery may be necessary in the setting of perforation or obstruction Today, colonic TB is uncommon but in the preantibiotic era, 70% of patients who died developed gastrointestinal TB Epidemiology [pathologyoutlines.com]
"Epidemiology" (PDF). Global tuberculosis control: epidemiology, strategy, financing. pp. 6–33. ISBN 978-92-4-156380-2. [ permanent dead link ] FitzGerald JM, Wang L, Elwood RK (February 2000). "Tuberculosis: 13. [en.wikipedia.org]
Pathophysiology
[…] gastrointestinal TB have ileocecal disease Also other colorectal sites Multiple sites in 28 - 44% Ileocecum is most common site of abdominal and gastrointestinal TB Isolated colorectal involvement is uncommon - only 10.8% of abdominal gastrointestinal TB Pathophysiology [pathologyoutlines.com]
References: [7] [8] [9] Pathophysiology Clinical features Latent infection Asymptomatic The patient is not contagious. [amboss.com]
PATHOPHYSIOLOGY OF ABDOMINAL TB There are several ways by which tuberculosis can involve abdomen (Table 1 )[ 10, 11 ]. Firstly, the tubercle bacilli may enter the intestinal tract through the ingestion of infected milk or sputum. [ncbi.nlm.nih.gov]
Prevention
"Drug-resistant tuberculosis: etiology, management and prevention". Seminars in Respiratory Infections. 9 (2): 104–12. PMID 7973169. Centers for Disease Control and Prevention (CDC) (March 2006). [en.wikipedia.org]
References: [4] [25] [26] [27] [28] [29] Prevention [amboss.com]
Contact screening See the separate article on Tuberculosis Prevention and Screening. [patient.info]
Therefore, ITB should be always kept in mind in this situation and survey, such as culture or PCR for mycobacterial DNA, should be considered in TB endemic areas to prevent further depressing scenario. [springerplus.springeropen.com]
Early diagnosis and initiation of antituberculous therapy and surgical treatment are essential to prevent morbidity and mortality. [ncbi.nlm.nih.gov]