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Ileoscopy in patients with ileocolonic tuberculosis
S P Misra1, Vatsala Misra, Manisha Dwivedi
1Department of Gastroenterology, Motilal Nehru Medical College, Allahabad 211 001, India. spmisra@sancharnet.in
World Journal of Gastroenterology
|April 28, 2007
Summary
Retrograde terminal ileoscopy is crucial for diagnosing ileocolonic tuberculosis. This method helps identify tuberculosis in the terminal ileum, even when colonic lesions are absent, improving diagnostic accuracy.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Endoscopy
Background:
- Ileocolonic tuberculosis diagnosis can be challenging.
- Standard colonoscopy may miss isolated terminal ileum involvement.
Purpose of the Study:
- To evaluate the diagnostic utility of retrograde terminal ileoscopy in suspected ileocolonic tuberculosis.
- To determine if terminal ileum examination improves tuberculosis detection rates.
Main Methods:
- Retrospective analysis of patients undergoing colonoscopy for suspected ileocolonic tuberculosis (2000-2004).
- Inclusion criteria: histological confirmation of tuberculosis (caseating or non-caseating granulomas/epithelioid cells) and response to anti-tuberculosis drugs.
- Focus on cases where retrograde terminal ileoscopy was performed.
Main Results:
- 11 out of 53 patients had terminal ileum involvement.
- Tuberculosis was diagnosed solely from terminal ileum biopsies in some cases, despite non-specific colonic findings.
- Histology of ileal lesions included noncaseating granulomas and epithelioid cells.
Conclusions:
- Retrograde terminal ileoscopy should be standard in suspected ileocolonic tuberculosis.
- It increases the detection of tuberculosis, especially when isolated to the terminal ileum.
- This enhances the timely diagnosis of ileocolonic tuberculosis.
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