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Two cases of colonic tuberculosis presenting with massive melena
T Namisaki1, H Yoshiji, M Fujimoto
1Third Department of Internal Medicine, Nara Medical University, Nara, Japan.
International Journal of Clinical Practice
|January 14, 2005
Summary
Massive melena is a rare symptom of colonic tuberculosis. This study highlights two cases where colonic tuberculosis presented with massive melena, emphasizing the need for clinical suspicion.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pulmonology
Background:
- Colonic tuberculosis (CTB) presents with diverse clinical symptoms.
- Massive melena is an exceptionally rare manifestation of CTB.
Observation:
- Two cases of CTB presenting with massive melena are reported.
- Neither patient had active pulmonary tuberculosis.
- Initial diagnostic evaluations, including colonoscopy and histology, were inconclusive for tuberculosis in one case.
Findings:
- Both patients showed significant improvement after a 4-week course of antituberculous agents.
- Polymerase chain reaction confirmed Mycobacterium tuberculosis in one patient's colonic biopsy.
- Clinical presentation mimicked colon carcinoma in one case.
Implications:
- Massive melena should raise suspicion for colonic tuberculosis, even without pulmonary involvement.
- Early empirical treatment with antituberculous agents can be effective.
- CTB should be considered in the differential diagnosis of unexplained massive melena.