Background: Tuberculosis in India continues to be a major health problem with approximately one eight of total cases being extra pulmonary. The gastrointestinal tract is involved in 66-75% of cases of abdominal tuberculosis. The pathologist plays a central role in diagnosis of intestinal tuberculosis (ITB). Many intestinal lesions especially non-neoplastic share the same clinical background, where characteristic pathological features not only suggest specific diagnosis but also the extent and severity of the disease. Aim: To study the profile of tuberculous lesions of small and large intestine including appendix in relation to age and sex distribution, the clinical presentation and regional distribution of the lesions. Method: A prospective study of 30 diagnosed cases of ITB encounterd in surgically excised specimens of small and large bowel including appendix carried over a period of five years.The diagnosis was based on the presence of caseating or non-caseating epithelioid cell granulomas, acid-fast bacilli (AFB) on histology. Results: Intestinal obstruction was the most frequent clinical presentation in ITB cases in this series.The mean age was 34.2 years with M: F ratio of 2:1. Ileum and ileocaecal region weremost frequently involved. The three gross morphological forms of tuberculous enteritis seen were ulcerative in 70%, ulcero-hypertrophic in 20% and hypertrophic in 10 %cases. Characteristic caseating granulomas were seen in 60% cases. Conclusion: Along with clinical, radiological and endoscopic evaluation, the present study showed that histopathological analysis also plays an important role in the diagnostic and therapeutic approach to intestinal tuberculosis.

Keywords: Intestinal Tuberculosis (ITB); Acid- Fast Bacilli (AFB).