Trend of large bowel tuberculosis and the relation with pulmonary tuberculosis

From 1965 to 1989, 60 cases of large bowel tuberculosis among 116 cases of abdominal tuberculosis are reviewed and analyzed. Lesions located in the cecum or ileocecal region were found in 49 of the 60 cases. Most of the patients (50/60) received surgical intervention, but the definite diagnoses had never been proved until surgery. The diagnoses were proved by histopathologic examination in these 50 cases. Antituberculosis medications were given for at least nine months in all patients. Twenty-nine of the 50 patients who received operations had primary anastomosis during the operations, and no leakage occurred. Evidence of pulmonary tuberculous lesions could be found in 40 of the 60 cases. Positive findings of tubercle bacilli in sputum smear or culture were noted in 13 cases. The positive rate of sputum examinations decreased during 1980 to 1989; 25.6 percent (10/39) were positive from 1965 to 1979 and 14 percent (3/21) were positive from 1980 to 1989. In the meantime, there was a steady decline in the cases of large bowel tuberculosis in the most recent few years. An antituberculosis program has been carried out in the past 40 years with remarkable effect in the Taiwan area, but the possibility of intestinal tuberculosis still exists. The authors suggest that surgeons keep tuberculosis in mind when they are dealing with patients who suffer from intestinal obstruction of unknown origin with the suspected findings of pulmonary tuberculosis in chest x-ray films.