A Case of Intestinal Tuberculosis

Taufiqul Haque1, Selina Aktar2, Atiqur Rahman3, Jalal Mohsin Uddin4, Habiba Khatun5

Abstract:
Tuberculosis can involve any part of the gastrointestinal tract and abdominal TB
is the sixth most frequent site of extrapulmonary involvement. Tuberculosis
bacteria reach the gastrointestinal tract via haematogenous spread, ingestion of
infected sputum, or direct spread from infected contiguous lymph nodes and
fallopian tubes. The gross pathology is characterized by transverse ulcers, fibrosis,
thickening and stricturing of the bowel wall, enlarged and matted mesenteric
lymph nodes, omental thickening, and peritoneal tubercles.
Peritoneal tuberculosis occurs in three forms : wet type with ascitis, dry type
with adhesions, and fibrotic type with omental thickening and loculated ascites.
The most common site of involvement of the gastrointestinal tuberculosis is the
ileocaecal region. Ileocaecal and small bowel tuberculosis presents with a palpable
mass in the right lower quadrant and/or complications of obstruction, perforation
or malabsorption especially in the presence of stricture.
Chest X-rays show evidence of concomitant pulmonary lesions in less than 25 per
cent of cases.Useful modalities for investigating a suspected case include small
bowel barium meal, barium enema, ultrasonography, computed tomographic scan
and colonoscopy.
Laparoscopy is a very useful investigation in doubtful cases. Management is with
conventional antitubercular therapy for at least 6 months. The recommended
surgical procedures today are conservative and a period of preoperative drug
therapy is controversial.
Key words: Abdominal tuberculosis - extrapulmonary - gastrointestinal ,
peritoneal TB.

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