Intestinal Tuberculosis in Surgical Pathology | Chapter 08 | Current Trends in Disease and Health Vol. 1
Background:
Intestinal tuberculosis (ITB) represents the most common type of abdominal TB.
Definitive diagnosis of intestinal tuberculosis is made on the basis of
morphological examination of surgical specimens in majority of cases as
clinico-radiological features are non-specific in initial stages of the
disease.
Aims:
To analyze the surgical pathology data on intestinal tuberculosis of the
hospital and to document findings of morphological examination.
Setting:
A descriptive study of intestinal tuberculous lesions encountered in surgical
specimens received during a period of three years in the histopathology section
of a tertiary care hospital.
Materials
and Methods: 40 cases of intestinal tuberculosis
out of 250 consecutive, surgically excised specimens of small and large bowel
were included in this study. One year retrospective and two years prospective
data is included in the study.
Results:
Intestinal obstruction was the most frequent clinical presentation followed by
perforation peritonitis in ITB cases in this series.9 patients had past history
of pulmonary and/or intestinal tuberculosis. Out of 31patients without past
history of TB, 25.80% were suspected of having TB preoperatively on the basis
of clinical and imaging findings. Ileal and ileo-caecal region was most
frequently involved. The three gross morphological forms of tuberculous
enteritis seen were ulcerative in 82.5%, ulcero-hypertrophic in 15% and
hypertrophic in 2.5% cases. Characteristic caseating granulomas were seen in
60% cases.
Conclusion:
Changes in clinical presentation of Intestinal TB are being observed. High
index of suspicion is needed at every step of diagnosis of intestinal TB as
many non-tuberculous lesions share same clinical and radiological findings.
Author(s) Details
Dr. Sandhya V. Poflee
Department of Pathology,
Government Medical College and Hospital, Nagpur, Maharashtra, India.
Dr. Balaji D. Baste, MBBS,
MD Pathology
Department of Pathology,
Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India.
Dr. Radha P. Munje, MBBS,
DTCD, MD (Med)
Department of Pulmonary
Medicine, Indira Gandhi Government Medical College and Hospital, Nagpur,
Maharashtra, India.
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