Gastrointestinal tuberculosis: An autopsy-based study

Area of Science:

• Pathology
• Infectious Diseases
• Gastroenterology

Background:

• Tuberculosis remains a major global health concern, causing significant morbidity and mortality.
• Gastrointestinal tuberculosis (GITB) is an uncommon manifestation involving the digestive tract and peritoneum.
• Accurate diagnosis of GITB is challenging, often leading to underdiagnosis.

Purpose of the Study:

• To analyze autopsy data of patients diagnosed with gastrointestinal tuberculosis.
• To gather information on the characteristics and prevalence of GITB from a Colombian pathology reference center.

Main Methods:

• Retrospective and descriptive study of autopsy reports.
• Analysis of 4,500 autopsies conducted between January 2004 and December 2020.
• Inclusion criteria: family authorization and microscopic confirmation of gastrointestinal tuberculosis.

Main Results:

• Forty-eight cases of gastrointestinal tuberculosis were identified.
• The majority of affected patients were male (72.9%), with a median age of 40.5 years.
• Human immunodeficiency virus (HIV) infection was present in 58.33% of cases. The terminal ileum was the most frequently involved site, with ulcers and thickened epithelium as common findings. Multiorgan compromise was noted.

Conclusions:

• Gastrointestinal tuberculosis poses diagnostic challenges, with a high potential for underdiagnosis.
• Autopsy studies are crucial for uncovering accurate data on the prevalence and impact of gastrointestinal tuberculosis.
• Findings underscore the importance of considering GITB in autopsy diagnoses, especially in patients with HIV and multiorgan involvement.