GI

Gastrointestinal Tuberculosis

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Gastrointestinal Tuberculosis, Tuberculous Enteritis

  • 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
  • Symptoms
  • Signs
  1. Blood in stool
  2. Palpable right lower quadrant mass
  • 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
  • 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
  • Management
  1. See Extrapulmonary Tuberculosis
  2. Treat for six months
  • Complications
  1. Intestinal Obstruction
  2. Bowel perforation
  3. Enteric fistulas