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[Primary intestinal tuberculosis]
V Salvati1, F Fumo, F P D'Armiento
1V Istituto di Chirurgia Generale e Geriatrica, Università degli Studi Federico II, Napoli.
Insights
This case study highlights a rare instance of primary colonic tuberculosis in Italy. Early diagnosis and treatment led to a full recovery, demonstrating effective management of this uncommon gastrointestinal infection.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Colorectal Surgery
Background:
- Tuberculosis (TB) incidence is rising in Italy, affecting both pulmonary and extrapulmonary sites.
- Primary colonic tuberculosis is an uncommon presentation of Mycobacterium tuberculosis infection.
Observation:
- A 52-year-old male presented with a six-month history of constipation, weight loss, and abdominal pain, followed by rectal bleeding.
- Colonoscopy revealed a colonic stricture and ileocecal ulcers.
- Initial hematological tests and chest X-ray were unremarkable.
Findings:
- Biopsies and cultures confirmed tuberculosis as the cause of the colonic lesions.
- The patient experienced an acute intestinal hemorrhage requiring surgical intervention.
Implications:
- Prompt diagnosis and a combination of surgical resection and anti-TB chemotherapy are crucial for managing primary colonic TB.
- This case underscores the importance of considering TB in the differential diagnosis of colonic pathologies, especially in endemic areas.
- Successful management resulted in a disease-free outcome at four-year follow-up.
Abstract:
Tuberculosis, with its pulmonary and extrapulmonary localizations, is rapidly increasing in Italy. The authors describe a case of a primary colonic tuberculosis in a 52-year-old Caucasian man. At admission the patient reported a 6-month history of constipation, weight loss and abdominal pain. He had rectal bleeding in the last two weeks. Haematological tests and chest X-ray were negative. Colonoscopy showed a stricture in the proximal transverse colon and multiple ulcers in the ileocecal tract. Multiple biopsies and culture demonstrated tuberculosis. The patient underwent a right hemicolectomy after an episode of acute intestinal hemorrhage and received pharmacological treatment for nine months. After four years he is still free of disease.