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Indian Journal of Pathology: Research and Practice

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Clinicopathological Study of Tuberculous Lesions of Small and Large Intestine (Including Appendix)

A.A. Bhure, Resident, Department of Pathology, Dr. Shankarrao Chavan Government Medical College (SCGMC) & Hospital, Nanded, Maharashtra 431606, India , S.A. Deshpande* , A.A. Bhure**

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Indian Journal of Pathology: Research and Practice 6(3(part-2)):p 713-718, Jul-Sep 2017. | DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.6317.35

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Abstract

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). 

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DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.6317.35

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