CLINICAL DIAGNOSTIC CRITERIA FOR SUSPECTED ILEOCAECAL TUBERCULOSIS
Abstract
Background: Ileocecal Tuberculosis (TB) is difficult to diagnose clinically as getting histologicalspecimens means resorting to surgery, which is often hazardous and complicated in sick, anemicand emaciated patients with malabsortion syndrome. The present study was undertaken as anattempt to devise clinical criteria for diagnosis of ileocecal TB without resorting to invasivesurgery. Methodology: 52 patients with suspected ileocecal TB were assigned pre-determinedcriteria based on clinical signs, symptoms and simple laboratory investigations. Criteria forexclusion were also devised; patients were followed up for an average of 1.1 years. Clinicalresponse 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 oftreatment. All patients gained a minimal of 2 kg over 6 weeks and 32 patients gained more than10% of body weight within 3 months; the difference in mean weights before and after 3 monthstreatment was highly significant (p<0.001). Conclusions: In patients with suspected ileocecaltuberculosis, predetermined clinical criteria can be readily applied for early diagnosis, withoutresorting 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
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
