Cecal obstruction due to primary intestinal tuberculosis: a case series

Area of Science:

• Gastroenterology
• Infectious Diseases
• Surgical Pathology

Background:

• Primary intestinal tuberculosis is an uncommon form of tuberculosis.
• It often presents with symptoms that can be mistaken for other gastrointestinal conditions.
• While medical management is preferred, surgical intervention may be necessary for complex cases.

Purpose of the Study:

• To present two cases of primary intestinal tuberculosis.
• To highlight diagnostic challenges and the importance of considering tuberculosis in differential diagnoses.
• To emphasize the role of timely treatment in patient outcomes.

Main Methods:

• Case report of two patients with misdiagnosed primary intestinal tuberculosis.
• Diagnostic procedures included histopathology, cell culture, and polymerase chain reaction (PCR).
• Surgical interventions (hemicolectomy, attempted excision) were performed based on initial misdiagnoses.

Main Results:

• Initial misdiagnoses included colonic cancer and Crohn's disease complication.
• Histopathology confirmed tuberculous origin in one case; PCR and culture identified Mycobacterium tuberculosis in the other.
• Both patients responded well to anti-tuberculosis therapy post-operatively.

Conclusions:

• Gastrointestinal tuberculosis should be considered in the differential diagnosis of various bowel pathologies.
• Changes in the use of immunosuppressants and novel pharmaceuticals may influence tuberculosis prevalence.
• Accurate diagnosis and prompt treatment are vital for managing intestinal tuberculosis.