Skip to main content
Top
Published in: Journal of Medical Case Reports 1/2011

Open Access 01-12-2011 | Case report

Cecal obstruction due to primary intestinal tuberculosis: a case series

Authors: Antonis Michalopoulos, Vassilis N Papadopoulos, Stavros Panidis, Theodossis S Papavramidis, Anastasios Chiotis, George Basdanis

Published in: Journal of Medical Case Reports | Issue 1/2011

Login to get access

Abstract

Introduction

Primary intestinal tuberculosis is a rare variant of tuberculosis. The preferred treatment is usually pharmaceutical, but surgery may be required for complicated cases.

Case presentation

We report two cases of primary intestinal tuberculosis where the initial diagnosis was wrong, with colonic cancer suggested in the first case and a Crohn's disease complication in the second. Both of our patients were Caucasians of Greek nationality. In the first case (a 60-year-old man), a right hemicolectomy was performed. In the second case (a 26-year-old man), excision was impossible due to the local conditions and peritoneal implantations. Histopathology revealed an inflammatory mass of tuberculous origin in the first case. In the second, cell culture and polymerase chain reaction tests revealed Mycobacterium tuberculosis. Both patients were given anti-tuberculosis therapy and their post-operative follow-up was uneventful.

Conclusions

Gastrointestinal tuberculosis still appears sporadically and should be considered in the differential diagnosis along with other conditions of the bowel. The use of immunosuppressants and new pharmaceutical agents can change the prevalence of tuberculosis.
Appendix
Available only for authorised users
Literature
1.
go back to reference Sibartie V, Kirwan WO, O'Mahony S, Stack W, Shanahan F: Tuberculosis mimicking Crohn's disease: lessons relearned in a new era. Eur J Gastroenterol Hepatol. 2007, 19: 347-349. 10.1097/MEG.0b013e328012122b.CrossRefPubMed Sibartie V, Kirwan WO, O'Mahony S, Stack W, Shanahan F: Tuberculosis mimicking Crohn's disease: lessons relearned in a new era. Eur J Gastroenterol Hepatol. 2007, 19: 347-349. 10.1097/MEG.0b013e328012122b.CrossRefPubMed
2.
go back to reference Balamurugan R, Venkataraman S, John KR, Ramakrishna BS: PCR amplification of the IS6110 insertion element of Mycobacterium tuberculosis in fecal samples from patients with intestinal tuberculosis. J Clin Microbiol. 2006, 44: 1884-1886. 10.1128/JCM.44.5.1884-1886.2006.CrossRefPubMedPubMedCentral Balamurugan R, Venkataraman S, John KR, Ramakrishna BS: PCR amplification of the IS6110 insertion element of Mycobacterium tuberculosis in fecal samples from patients with intestinal tuberculosis. J Clin Microbiol. 2006, 44: 1884-1886. 10.1128/JCM.44.5.1884-1886.2006.CrossRefPubMedPubMedCentral
3.
go back to reference Chatzicostas C, Koutroubakis IE, Tzardi M, Roussomoustakaki M, Prassopoulos P, Kouroumalis EA: Colonic tuberculosis mimicking Crohn's disease: case report. BMC Gastroenterol. 2002, 2: 10-10.1186/1471-230X-2-10.CrossRefPubMedPubMedCentral Chatzicostas C, Koutroubakis IE, Tzardi M, Roussomoustakaki M, Prassopoulos P, Kouroumalis EA: Colonic tuberculosis mimicking Crohn's disease: case report. BMC Gastroenterol. 2002, 2: 10-10.1186/1471-230X-2-10.CrossRefPubMedPubMedCentral
4.
go back to reference Epstein D, Watermeyer G, Kirsch R: The diagnosis and management of Crohn's disease in populations with high-risk rates for tuberculosis. Aliment Pharmacol Ther. 2007, 25: 1373-1388. 10.1111/j.1365-2036.2007.03332.x.CrossRefPubMed Epstein D, Watermeyer G, Kirsch R: The diagnosis and management of Crohn's disease in populations with high-risk rates for tuberculosis. Aliment Pharmacol Ther. 2007, 25: 1373-1388. 10.1111/j.1365-2036.2007.03332.x.CrossRefPubMed
5.
go back to reference Singh V, Kumar P, Kamal J, Prakash V, Vaiphei K, Singh K: Clinicocolonoscopic profile of colonic tuberculosis. Am J Gastroenterol. 1996, 91: 565-568.PubMed Singh V, Kumar P, Kamal J, Prakash V, Vaiphei K, Singh K: Clinicocolonoscopic profile of colonic tuberculosis. Am J Gastroenterol. 1996, 91: 565-568.PubMed
6.
go back to reference Donoghue HD, Holton J: Intestinal tuberculosis. Curr Opin Infect Dis. 2009, 22: 490-496. 10.1097/QCO.0b013e3283306712.CrossRefPubMed Donoghue HD, Holton J: Intestinal tuberculosis. Curr Opin Infect Dis. 2009, 22: 490-496. 10.1097/QCO.0b013e3283306712.CrossRefPubMed
7.
go back to reference Anand BS, Schneider FE, El-Zaatari FA, Shawar RM, Clarridge JE, Graham DY: Diagnosis of intestinal tuberculosis by polymerase chain reaction on endoscopic biopsy specimens. Am J Gastroenterol. 1994, 89: 2248-2249.PubMed Anand BS, Schneider FE, El-Zaatari FA, Shawar RM, Clarridge JE, Graham DY: Diagnosis of intestinal tuberculosis by polymerase chain reaction on endoscopic biopsy specimens. Am J Gastroenterol. 1994, 89: 2248-2249.PubMed
8.
go back to reference Marschall JB: Tuberculosis of the gastrointestinal tract and the peritoneum. Am J Gastroenterology. 1993, 88: 989-999. Marschall JB: Tuberculosis of the gastrointestinal tract and the peritoneum. Am J Gastroenterology. 1993, 88: 989-999.
9.
go back to reference Klimach OE, Ormerod LP: Gastrointestinal tuberculosis: a retrospective review of 109 cases in a district general hospital. Q J Med. 1985, 56: 569-578.PubMed Klimach OE, Ormerod LP: Gastrointestinal tuberculosis: a retrospective review of 109 cases in a district general hospital. Q J Med. 1985, 56: 569-578.PubMed
10.
go back to reference Sherman S, Rohwedder JJ, Ravikrishann KP, Weg JG: Tuberculous enteritis and peritonitis. Report of 36 general hospital cases. Arch Intern Med. 1980, 140: 506-508. 10.1001/archinte.140.4.506.CrossRefPubMed Sherman S, Rohwedder JJ, Ravikrishann KP, Weg JG: Tuberculous enteritis and peritonitis. Report of 36 general hospital cases. Arch Intern Med. 1980, 140: 506-508. 10.1001/archinte.140.4.506.CrossRefPubMed
11.
go back to reference Jakubowski A, Elwood RK, Enarson DA: Clinical features of abdominal tuberculosis. J Infect Dis. 1988, 158: 687-692. 10.1093/infdis/158.4.687.CrossRefPubMed Jakubowski A, Elwood RK, Enarson DA: Clinical features of abdominal tuberculosis. J Infect Dis. 1988, 158: 687-692. 10.1093/infdis/158.4.687.CrossRefPubMed
12.
go back to reference Shah S, Thomas V, Mathan M, Chacko A, Chandy G, Ramakrishna BS, Rolston DD: Colonoscopic study of 50 patients with colonic tuberculosis. Gut. 1992, 33: 347-351. 10.1136/gut.33.3.347.CrossRefPubMedPubMedCentral Shah S, Thomas V, Mathan M, Chacko A, Chandy G, Ramakrishna BS, Rolston DD: Colonoscopic study of 50 patients with colonic tuberculosis. Gut. 1992, 33: 347-351. 10.1136/gut.33.3.347.CrossRefPubMedPubMedCentral
13.
go back to reference al Karawi MA, Mohamed AE, Yasawy MI, Graham DY, Shariq S, Ahmed AM, al Jumah A, Ghandour Z: Protean manifestations of gastrointestinal tuberculosis. Report of 130 patients. J Clin Gastroenterol. 1995, 20: 225-232. 10.1097/00004836-199504000-00013.CrossRefPubMed al Karawi MA, Mohamed AE, Yasawy MI, Graham DY, Shariq S, Ahmed AM, al Jumah A, Ghandour Z: Protean manifestations of gastrointestinal tuberculosis. Report of 130 patients. J Clin Gastroenterol. 1995, 20: 225-232. 10.1097/00004836-199504000-00013.CrossRefPubMed
14.
go back to reference Bhargava DK, Tandon HD, Chawla TC, Tandon BN, Kapur BM: Diagnosis of ileocecal and colonic tuberculosis by colonoscopy. Gastrointest Endosc. 1985, 31: 68-70. 10.1016/S0016-5107(85)71995-5.CrossRefPubMed Bhargava DK, Tandon HD, Chawla TC, Tandon BN, Kapur BM: Diagnosis of ileocecal and colonic tuberculosis by colonoscopy. Gastrointest Endosc. 1985, 31: 68-70. 10.1016/S0016-5107(85)71995-5.CrossRefPubMed
15.
go back to reference Misra SP, Misra V, Dwivedi M, Gupta SC: Colonic tuberculosis: clinical features, endoscopic appearance and management. J Gastroenterol Hepatol. 1999, 14: 723-729. 10.1046/j.1440-1746.1999.01940.x.CrossRefPubMed Misra SP, Misra V, Dwivedi M, Gupta SC: Colonic tuberculosis: clinical features, endoscopic appearance and management. J Gastroenterol Hepatol. 1999, 14: 723-729. 10.1046/j.1440-1746.1999.01940.x.CrossRefPubMed
Metadata
Title
Cecal obstruction due to primary intestinal tuberculosis: a case series
Authors
Antonis Michalopoulos
Vassilis N Papadopoulos
Stavros Panidis
Theodossis S Papavramidis
Anastasios Chiotis
George Basdanis
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2011
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-5-128

Other articles of this Issue 1/2011

Journal of Medical Case Reports 1/2011 Go to the issue