Tuberculosis Unexpectedly Presented Along Gastrointestinal Tract in Surgical Ward
Journal of Surgery
Volume 5, Issue 1, February 2017, Pages: 1-7
Received: Feb. 3, 2017; Accepted: Feb. 21, 2017; Published: Mar. 15, 2017
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Noori H. Jasim, General and GI Surgery, Department of Surgery, Faculty of Medicine, University of Basra, Basra, Iraq
Hashim S. Khayat, Basra General Hospital, Basra, Iraq
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Little is known in our country particularly in Basra about tuberculous lesions affecting the gastrointestinal tract specifically solid and hallow organs such as liver, pancreas, stomach or intestine. Hence, this study aimed to report, describe and study these cases. The current study is retrospectively studied 12 patients who got tuberculous lesions along the gastrointestinal tract over the last 2 decades in Basra General Hospital (2 of them were gastric, 3 hepatic, 3 pancreatic, 3 small intestinal; one of them affecting duodenojejunal flexure, and lastly 1 perianal sinus ulcerating the nearby skin). All those patients underwent the required surgical operations. In all those patients, TB was diagnosed postoperatively by histopathology and all of them received anti-tuberculosis triple therapy for 6 months including INH, Rifampicin and Ethambutol. A long term scheduled follow up was done showing that all of them were improved except one elderly patient with TB pancreatitis died at early postoperative period. None of these cases effected with pulmonary tuberculosis previously or concomitantly. One case of hepatic tuberculosis had cervical and intra-abdominal lymphadenopathy. It is of interest to mention that extrapulmonary TB in solid and hallow organs of gastrointestinal tract should be considered when evaluating patients with gastrointestinal presentations and lesions such as ulcer, mass, abscess or perianal fistula in endemic areas and the potential for affecting these organs (along gastrointestinal tract) should be kept in mind and accounted for.
Tuberculosis, Gastrointestinal Tract, Surgical Ward
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Noori H. Jasim, Hashim S. Khayat, Tuberculosis Unexpectedly Presented Along Gastrointestinal Tract in Surgical Ward, Journal of Surgery. Vol. 5, No. 1, 2017, pp. 1-7. doi: 10.11648/j.js.20170501.11
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"Tuberculosis Fact sheet N°104". World Health Organization. November 2010.
"The sixteenth global report on tuberculosis World Health Organization (2011).
Kumar V, Abbas AK, Fausto N, Mitchell RN (2007). Robbins Basic Pathology (8th ed.). Saunders Elsevier. pp. 516–522. ISBN 978-1-4160-2973-1.
Dolin, Gerald L. Mandell, John E. Bennett, Raphael (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases (7th ed.). Philadelphia, PA: Churchill Livingstone/Elsevier. pp. Chapter 250. ISBN 978-0-443-06839-3.
Kabra, [edited by] Vimlesh Seth, S. K. (2006). Essentials of tuberculosis in children (3rd ed.). New Delhi: Jaypee Bros. Medical Publishers. p. 249. ISBN 978-81-8061-709-6.
Manual of Surgery. Kaplan Publishing. 2008. p. 75. ISBN 9781427797995.
Mehta J. B., Dutt A., Harvill L., and K. M. Mathews, “Epidemiology of extrapulmonary tuberculosis: a comparative analysis with pre-AIDS era 1991; 99 (5): 1134–1138.
Akgun E., Tekin F., Ersin S., et al. Isolated perianal tuberculosis. The Netherlands Journal of Medicine 2005; 63 (3): 115–117.
Yurt S., Filiz Kosar A., Isik N et al., “Two cases of pulmonary tuberculosis with extrapulmonary involvement in tongue and anus,” Respiratory Medicine Extra 2005; 1 (1): 1–3.
Marshal JB: Tuberculosis of the gastrointestinal tract and peritoneum. Am J Gastroenterol 1993; 88 (7): 989-99.
Todd A. Sheer, Walter J. Coyle: Gastrointestinal tuberculosis. Current Gastroenterology Reports 2003; 5 (4): 273-278.
Donoghue HD, Holton J. Intestinal tuberculosis. Curr Opin Infect Dis 2009; 22: 490.
Mehta J. B., Dutt A., Harvill L., et al. Epidemiology of extrapulmonary tuberculosis: a comparative analysis with pre-AIDS era. Chest 1991; 99 (5): 1134–1138.
Vanderpool DM, O'Leary PJ. Primary tuberculous enterocolitis. Surg Gynecol Obstet 1988; 167: 167-73.
Horland R. W., Varkey B. Anal tuberculosis: report of two cases and literature review. The American Journal of Gastroenterology 1992; 87: 1488–1491.
Gupta P. J. Ano-perianal tuberculosis—solving a clinical dilemma. African Health Sciences 2005; 5 (4): 345–347.
Gutman H., Kott I., Santo M., et al. Perianal tuberculosis: report of a case and review of the literature. Digestive Surgery 1985; 2 (2): 118–120.
Mathew S. Anal tuberculosis: report of a case and review of literature. International Journal of Surgery 2008; 6 (6): e36–e39.
Sultan S., Azria F., Bauer P., et al. Anoperineal tuberculosis: diagnostic and management considerations in seven cases. Diseases of the Colon and Rectum 2002; 45 (3): 407–410.
Petrosyan M, Mason RJ. Tuberculous enteritis presenting as small-bowel obstruction. Clin Gastroenterol Hepatol 2006; 4: xxiii.
Dasgupta A, Singh N, Bhatia A. Abdominal tuberculosis: a histo-pathological study with special reference to intestinal perforation and mesenteric vasculopathy. J Lab Physicians 2009; 1: 56.
Ha HK, Ko GY, Yu ES, et al. Intestinal tuberculosis with abdominal complications: radiologic and pathologic features. Abdom Imaging 1999; 24: 32.
Ozarmagan G., Keles S., Yazganoglu K. D., et al. Delayed diagnosis in a case of perianal tuberculosis: differential diagnosis in perianal ulceration Indian J Dermatol 2010; 55: 309–310.
Miteva L. and Bardarov E. Perianal tuberculosis: a rare case of skin ulceration? Acta Derm Venereol 2002; 82: 481–482.
Alvarez C. J. L., Gutierre A. V. M. z, Del Riego T. J., et al. Perianal ulcers of tubercular origin. A report of 3 new cases Rev Esp Enferm Dig 1992; 81: 46–48.
Netoa I. J. F. C, Siáa O. N., Lopes E. A., et al. Perianal tuberculosis: A rare disease of late diagnosis. Journal of Coloproctology 2014; 34 (2): 124–127.
Walsh T. J., Mulholland J. H. Laryngeal and perianal tuberculosis simulating laryngeal and perianal carcinoma, Johns Hopkins Medical Journal 1981; 149 (4): 135–137.
Ibn Majdoub Hassani K., Ait Laalim S., Toughrai I. et al. Perianal Tuberculosis: A Case Report and a Review of the Literature. Infectious Diseases 2012; Volume 2012 (2012), Article ID 852763.
Ichihashi K., Katoh N., Takenaka H., et al. Orificial tuberculosis: presenting as a refractory perianal ulcer. Acta Derm Venereol 2004; 84: 331–332.
Sharma M. P., Bhatia V. Abdominal tuberculosis. Indian J Med Res 2004; 120: 305–315.
Shahrokh S, Bagher Miri M., Safari M. T. et al. Pancreatic Tuberculosis: An overview J Pancreas (Online) 2015; 16 (3): 232-238.
Auerbach O. Acute Generalized Miliary Tuberculosis. Am J Pathol 1944; 20: 121-136. [PMID: 19970738].
Nagar AM l: Pancreatic tuberculosis: a clinical and imaging review of 32 cases). J Comput Assist Tomogr 2009; 33: 136-141. [PMID: 19188801].
Khan R, Abid S, Jafri W, et al. Diagnostic dilemma of abdominal tuberculosis in non-HIV patients: an ongoing challenge for physicians. World J Gastroenterol 2006; 12: 6371-5. [PMID: 17072964].
Turan M, Sen M, Koyuncu A, et al. Pancreatic psuedotumor due to peripancreatic tuberculous lymphadenitis. Pancreatology 2002; 2: 561-4. [PMID: 12435870].
Sonthalia N, Ray S, Pal P, et al. Fine needle aspiration diagnosis of isolated pancreatic tuberculosis: A case report. World J Clin Cases 2013; 16 (1): 181-6. [PMID: 24303497].
Crowson MC, Perry M, Burden E. Tuberculosis of the pancreas: a rare cause of obstructive jaundice. Br J Surg 1984; 71: 239. [PMID: 6697132].
Teo LL, Venkatesh SK, Ho KY. Clinics in diagnostic imaging. Singapore Med J 2007; 48: 687-692. [PMID: 17609835].
Saluja SS, Ray S, Pal S, et al. Hepatobiliary and pancreatic tuberculosis: a two decade experience. BMC Surg 2007; 7: 10. [PMID: 17588265].
Mert A., Ozaras R., Tabak F., et al. Localized hepatic tuberculosis. Eur J Intern Med 2003; 14: 511-2.
Ferrari T. C. A; Couto C. M.; Vilaça T. S., et al. Localized hepatic tuberculosis presenting as fever of unknown origin: case report. Brazilian Journal of Infectious Diseases 2006; 10 (5): 1-4.
Tritou I., Prassopoulos P., Daskalogiannaki M., et al. Miliary hepatic tuberculosis not associated with splenic or lung involvement. Acta Radiol 2000; 41: 478-81.
Chien R. N., Lin P. Y., Liaw Y. F. Hepatic tuberculosis: comparison of miliary and local form. Infection 1995; 23: 5-12.
Hersch C. Tuberculosis of the liver: a study of 200 cases. S Afr Med 1964; 38: 857-63.
Kok K. Y. Y., Yapp S. K. S. Isolated hepatic tuberculosis: report of five cases and review of the literature. J Hepatobiliary Pancreat Surg 1999; 6: 195-8.
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