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Title: Case report: gastrointestinal tuberculosis simulating Crohn's disease.
Title Abreviation: J Gastroenterol Hepatol Date of Pub: 1996 Jun
Author: Kaushik SP; Bassett ML; McDonald C; Lin BP; Bokey EL;
Issue/Part/Supplement: 6 Volume Issue: 11 Pagination: 532-4
MESH Headings: Adult; Case Report; Crohn Disease (*DI); Diagnosis, Differential; Endoscopy, Gastrointestinal; Human; Intestine, Small (RA); Male; Thoracic Radiography; Tuberculosis, Gastrointestinal (*DI/PA/SU); -AA-;
Journal Title Code: A6J Publication Type: JOURNAL ARTICLE
Date of Entry: 961216NEntry Month: 9702
Country: AUSTRALIA Index Priority: 2
Language: Eng Unique Identifier: 96384417
Unique Identifier: 96384417 ISSN: 0815-9319
Abstract: A male Caucasian presented with abdominal pain and a right iliac fossa mass. There were no risk factors for Mycobacterium tuberculosis infection. He was investigated by upper and lower gastrointestinal endoscopy, chest and small bowel radiology. The latter showed stricturing of the third and fourth parts of the duodenum, mid-jejunum and terminal ileum. Biopsies were non-specific and he was thought to have Crohn's disease. Subsequent treatment with corticosteroids resulted in improved well being and weight gain; however, the patient demonstrated disease progression with the development of complex fistulae and Escherichia coli septicaemia. At surgery the patient was found to have an ileal inflammatory mass with fistulae to the sigmoid colon. The terminal ileum, fistulae and a segment of colon were resected. Treatment with anti-tuberculous drugs ensued and the patient is now asymptomatic after 15 months of follow-up. This case serves to highlight the difficulty in making the diagnosis of gastrointestinal tuberculosis, a disease that may mimic Crohn's disease, and the need for caution in the use of corticosteroids in any disease in which tuberculosis enters into the differential diagnosis. The role of surgery in making the diagnosis and managing the complications, in conjunction with anti-tuberculous drugs, and the prospect of cure are exemplified by this case.
Abstract By: Author
Address: Gastroenterology Unit, Woden Valley Hospital, ACT, Australia.