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The changing pattern of intestinal tuberculosis: 30 years' experience
1Department of Surgery, Veterans General Hospital-Taipei, Taiwan, Republic of China.
Summary
Intestinal tuberculosis cases declined then rose, with older patients diagnosed post-surgery. Increased suspicion is vital for early diagnosis of this challenging gastrointestinal disease.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Surgical Pathology
Background:
- Tuberculosis incidence has seen a recent resurgence after years of decline.
- Intestinal tuberculosis presents diagnostic challenges due to its insidious nature.
Purpose of the Study:
- To analyze trends in intestinal tuberculosis patterns and distribution.
- To emphasize the need for heightened surgical suspicion for intestinal tuberculosis.
Main Methods:
- Retrospective analysis of 134 intestinal tuberculosis patients (1965-1995).
- Review of patient records, bacteriological data, and pathological specimens.
- Data extraction using a standardized questionnaire.
Main Results:
- A decrease in intestinal tuberculosis cases was observed post-1975, with a slight increase noted since 1990.
- Patients diagnosed after 1990 were older (average 64.8 years) compared to earlier cases (average 44.4 years).
- Most patients (81.3%) lacked a definitive diagnosis before surgery; 29.1% had active pulmonary tuberculosis.
Conclusions:
- Rising intestinal tuberculosis cases may be linked to increased life expectancy and treatment relapses.
- The non-specific presentation complicates diagnosis, often delaying definitive treatment.
- Enhanced clinical suspicion and familiarity with the disease are crucial for timely diagnosis and preventing unnecessary surgeries.