Radiological evaluation of complications of intestinal tuberculosis

Complications of intestinal tuberculosis may be masked. This study aims to heighten awareness of these unusual clinical complications and the radiological findings in such cases. Over a period of 5 years, 21 patients with proven intestinal tuberculosis, 13 of whom presented with complications, are presented in this report. Radiological diagnosis was by barium gastrointestinal studies and computed tomographic (CT) evaluation. Surgical specimens and histopathology confirmed the diagnosis. The commonest complication was intestinal obstruction (N = 6). Others were esophagobronchial and duodenocolic fistulas (N = 2), significant gastrointestinal hemorrhage (N = 3) caused by ulcers in the small bowel and colon, and malabsorption syndrome (N = 3) caused by diffuse small bowel infiltration in 2 cases and duodenocolic fistula in the third case. None of the patients presented were immunocompromised. Though uncommon, tuberculosis should be considered in patients presenting clinically with intestinal obstruction, significant gastrointestinal hemorrhage and malabsorption state.