Gastrointestinal Tuberculosis

Sep 16, 2019 admin NHIỄM KHUẨN, TIÊU HÓA 0

Gastrointestinal Tuberculosis

Aka: Gastrointestinal Tuberculosis, Tuberculous Enteritis

II. Pathophysiology

  1. Involves any part of Gastrointestinal tract
  2. Ileocecal most commonly affected
  3. Risk of contracting gastrointestinal Tb
    1. Parallels severity of pulmonary disease
  4. Transmission
    1. Swallowing infected Sputum or contaminated food
    2. Hematogenous spread
    3. Contiguous spread from involved tissue

III. Symptoms

  1. Fever
  2. Weight loss
  3. Abdominal Pain
  4. Diarrhea

IV. Signs

  1. Blood in stool
  2. Palpable right lower quadrant mass

V. Differential Diagnosis

  1. Crohn’s Disease
    1. Critical to differentiate from Tuberculosis
    2. Crohn’s Treatment disseminates Tuberculosis
  2. Infection
    1. Yersinia
    2. Actinomyces
    3. Amebiasis
  3. Colon Cancer

VI. Diagnosis

  1. Endoscopy
    1. Mucosal injury
      1. Ulcerations
      2. Hypertrophic lesions
      3. Dense bandlike fibrosis
    2. Mucosal biopsy shows Acid Fast Bacilli (low yield)
    3. Culture of biopsy specimens
  2. CT Abdomen
  3. Barium Enema
    1. Shortened and retracted cecum

VII. Management

  1. See Extrapulmonary Tuberculosis
  2. Treat for six months

VIII. Complications

  1. Intestinal Obstruction
  2. Bowel perforation
  3. Enteric fistulas

IX. References

  1. Marshall (1993) Am J Gastroenterol 88:989-99 [PubMed]

Images: Related links to external sites (from Bing)

These images are a random sampling from a Bing search on the term “Gastrointestinal Tuberculosis.” Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images

BÀI LIÊN QUAN