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Ileocecal Tuberculosis


Presentation

  • Three cases of ileocecal tuberculosis are presented with a review of pathogenesis, diagnosis and therapy.[ncbi.nlm.nih.gov]
  • Two cases of ileocecal tuberculosis are presented. The diagnosis was achieved by endoscopic fine needle aspiration cytology (FNAC), while endoscopic biopsies and brush cytology were negative.[ncbi.nlm.nih.gov]
  • 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]
  • 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]
  • The case study presentation provides an excellent review tool for the American Board of Colon and Rectal Surgery exam.[books.google.com]
Chronic Cough
  • 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]
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]
Fever
  • 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]
  • Clinical manifestations of diarrhea, abdominal pain, right lower quadrant tenderness, can also have abdominal mass, unexplained intestinal obstruction, accompanied by fever, night sweats and other tuberculosis toxic symptoms. 3.X line barium meal inspection[healthfrom.com]
  • 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]
  • Likely cause is Exam: AIIMS Pre PG - May - 2010 A pt presents with acute rheumatic carditis with fever.[quespedia.com]
  • He had no history of fever. He had appendectomy about 6 months before presentation at another facility on account of worsening lower abdominal pain without any resolution of the pain.[jmedtropics.org]
Weight Loss
  • 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]
  • Patients infected with Mycobacterium Tuberculosis(Mtb) may present with ileocecal infection, weight loss and bleeding per rectum.[journals.lww.com]
  • Our patient had nonspecific gastrointestinal complaints with the exception of weight loss. Because of the weight loss history, anemia, and abdominal fullness, malignancy was the initial differential diagnosis.[pubs.sciepub.com]
  • […] with fever, 75% with vomiting and all cases presented with weight loss.[ispub.com]
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]
Chronic Fatigue Syndrome
  • Kradin has a number of clinical interests including Chronic Fatigue Syndrome, Interstitial Lung Disease, Multiple Chemical Sensitivity and Pulmonary Immunology. He also holds an Associate Professor position of Pathology at Harvard Medical School.[books.google.com]
Coronary Artery Disease
  • Probable cause is – Exam: AIIMS Pre PG Nov 2009 A 65 years old patient of coronary artery disease was on aspirin for 2 years. He now complains of black stools. Abdominal examination is normal. What ...[quespedia.com]
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]
  • Clinical manifestations of diarrhea, abdominal pain, right lower quadrant tenderness, can also have abdominal mass, unexplained intestinal obstruction, accompanied by fever, night sweats and other tuberculosis toxic symptoms. 3.X line barium meal inspection[healthfrom.com]
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]
  • One patient was a 25-year-old male presenting with chronic abdominal pain, diarrhea, low-grade fever, loss of appetite and weight loss. Colonoscopy revealed ulcers in the terminal ileum and cecum.[nature.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]
Abdominal Tenderness
  • Presenting clinical features included abdominal pain 80.6%, weight loss 74.6%, fever 40.3%, diarrhea/constipation 25.4%, diarrhea 16.4%, blood per rectum 11.9%, abdominal tenderness 37.3%, abdominal mass 13.4%, and lymphadenopathy 1.5%.[nature.com]
Right Lower Quadrant Tenderness
  • Clinical manifestations of diarrhea, abdominal pain, right lower quadrant tenderness, can also have abdominal mass, unexplained intestinal obstruction, accompanied by fever, night sweats and other tuberculosis toxic symptoms. 3.X line barium meal inspection[healthfrom.com]
Excitement
  • It is an exciting result that some patients with suspicious tuberculous colitis, who showed no active ulcer and significant resolution on follow-up colonoscopy without any other specific clue for tuberculosis, were also confirmed as tuberculous colitis[wjgnet.com]

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]
Colonic Stricture
  • Tuberculous colonic strictures: impact of dilation on diagnosis . Endoscopy 2004; 36 : 1099–1103. 36. Patel MP , De I . Segmental tuberculosis of the colon with entero-colic fistula . Br J Radiol 1972; 45 : 150–152. 37.[nature.com]
  • Ileocaecoplasty and coloplasty are also advocated for ileocaecal and colonic strictures, respectively.[ots1.narod.ru]
Normocytic Normochromic Anemia
  • normochromic anemia Discussion Thread on this Question Passion may possibly be the hectic concern in the personal life nicely expansion of what our staff members prefer.[quespedia.com]
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]
  • On the high degree of suspected intestinal tuberculosis cases, such as anti-tuberculosis treatment 2 to 6 weeks effective, can make the clinical diagnosis of intestinal tuberculosis.[healthfrom.com]
  • The barium enema reveals quickly and early the overall status of the colon and it can then guide endoscopy and biopsy together with subsequent treatment.[books.google.com]

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]
  • Introduction Etiology Prevention Examine Differential diagnosis Introduction Ileocecal tuberculosis is caused by Mycobacterium tuberculosis infection! Intestinal tuberculosis is the most common in digestive system tuberculosis.[healthfrom.com]
  • 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]
  • Eosinophilic enteritis is a rare cause of intestinal obstruction with varied etiology which can mimic ileocecal tuberculosis.[ijhas.in]
  • 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]

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 [ 3 ] The rates of TB have stabilised in the UK over a period of seven years, following the increase in the incidence from 1990 to 2005.[patient.info]
Sex distribution
Age distribution

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 Alveolar macrophages phagocytose the TB bacteria but cannot eliminate them.[amboss.com]

Prevention

  • Introduction Etiology Prevention Examine Differential diagnosis Introduction Ileocecal tuberculosis is caused by Mycobacterium tuberculosis infection! Intestinal tuberculosis is the most common in digestive system tuberculosis.[healthfrom.com]
  • References: [4] [24] [25] [26] [27] [28] 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]
  • Pyridoxine hydrochloride (5 - 10 mg/day) must be given along with isoniazid to prevent peripheral neuropathy.[ots1.narod.ru]

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