CLINICAL DIAGNOSTIC CRITERIA FOR SUSPECTED ILEOCAECAL TUBERCULOSIS

Salim Afzal, Iftikhar Qayum, Iftikhar Ahmad, Salma Kundi

Abstract


Background: Ileocecal Tuberculosis (TB) is difficult to diagnose clinically as getting histological
specimens means resorting to surgery, which is often hazardous and complicated in sick, anemic
and emaciated patients with malabsortion syndrome. The present study was undertaken as an
attempt to devise clinical criteria for diagnosis of ileocecal TB without resorting to invasive
surgery. Methodology: 52 patients with suspected ileocecal TB were assigned pre-determined
criteria based on clinical signs, symptoms and simple laboratory investigations. Criteria for
exclusion were also devised; patients were followed up for an average of 1.1 years. Clinical
response was assessed by complete resolution of symptoms and signs within 3 months.
Results: All 52 patients completed the study and all became symptom free within 3 months of
treatment. All patients gained a minimal of 2 kg over 6 weeks and 32 patients gained more than
10% of body weight within 3 months; the difference in mean weights before and after 3 months
treatment was highly significant (p<0.001). Conclusions: In patients with suspected ileocecal
tuberculosis, predetermined clinical criteria can be readily applied for early diagnosis, without
resorting to surgery and with excellent clinical response.

References


Aliyu MH, Salihu HM. Tuberculosis and HIV disease: two

decades of a dual epidemic. Wien Klin Wochenschr 2003;

(19–20):685-97.

WHO report for Pakistan 2004. Available from:

http://www.who.int/GlobalAtlas/predefinedReports/TB/PDF

_Files/PK_2004_Detailed.pdf

WHO report for Afghanistan 2004. Available from:

http://www.who.int/GlobalAtlas/predefinedReports/TB/PDF

_Files/AF_2004_Detailed.pdf

WHO EMRO report 2005. Available from:

http://www.emro.who.int/stb/

Shukla HS, Hughes LE. Abdominal tuberculosis in 1970s: a

continuing problem. Br J Surg1978; 65(6):403-5.

Guth AA, Kim U. The reappearance of abdominal

tuberculosis. Surg Gynecol Obstet 1991; 172(6):432-6.

Horvath KD, Whelan RL. Intestinal tuberculosis: Return of

an old disease. Am J Gastroenterol1998; 93(5):692-6.

Khan MR, Khan IR, Pal KM. Diagnostic issues in abdominal

tuberculosis. J Pak Med Assoc 2001; 51(4):138-42.

Martinez Tirado P, Lopez De Hierro Ruiz M, Martinez

Garcia R, Martinez Cara JG, Martin Rodriguez MM, Castilla

Castellano MM. Intestinal tuberculosis. A diagnostic

challenge Gastroenterol Hepatol 2003;26(6):351-4.

Patel N, Amarapurkar D, Agal S, Baijal R, Kulshrestha P,

Pramanik S et al. Gastrointestinal luminal tuberculosis:

establishing the diagnosis. J Gastroenterol Hepatol 2004;

(11):1240-6.

J Ayub Med Coll Abbottabad 2006; 18(4)

Perez del Rio MJ, Fresno Forcelledo M, Diaz Iglesias JM,

Veiga Gonzalez M, Alvarez Prida E, Ablanedo Ablanedo P et

al. Intestinal tuberculosis, a difficult suspected diagnosis. An

Med Interna 1999;16(9):469-72.

Blumberg HM, Leonard MK Jr. Tuberculosis: Forms of

Tuberculosis. ACP Medicine Online 2002. Posted

/07/2006. Available from:

http://www.medscape.com/viewarticle/534783

Alvares JF, Devarbhavi H, Makhija P, Rao S, Kottoor R.

Clinical, colonoscopic, and histological profile of colonic

tuberculosis in a tertiary hospital. Endoscopy 2005;

(4):351-6.

Misra SP, Misra V, Dwivedi M, Gupta SC. Colonic

tuberculosis: clinical features, endoscopic appearance and

management. J Gastroenterol Hepatol 1999;14(7):723-9.

Chang HT, Leu S, Hsu H, Lui WY. Abdominal tuberculosis.

a retrospective analysis of 121 cases. Zhonghua Yi Xue Za

Zhi (Taipei) 1991;47(1):24-30.

Pereira JM, Madureira AJ, Vieira A, Ramos I. Abdominal

tuberculosis: imaging features. Eur J Radiol 2005;55(2):173-

Nakano H, Jaramillo E, Watanabe M, Miyachi I, Takahama

K, Itoh M. Intestinal tuberculosis: findings on doublecontrast barium enema. Gastrointest Radiol 1992; 17(2):108-

Han JK, Kim SH, Choi BI, Yeon KM, Han MC. Tuberculous

colitis. Findings at double-contrast barium enema

examination. Dis Colon Rectum 1996; 39(11):1204-9


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