Chapter 25 : Gastrointestinal Tuberculosis

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Involvement of the gastrointestinal tract by tuberculosis (TB) remains a prevalent and relevant disease entity in certain areas of the world and in certain at-risk patient populations. Although the more common forms of extrapulmonary TB (EPTB) include lymph node, pleural, disseminated, pericardial, and meningeal TB, gastrointestinal TB is believed to be the next most frequent form ( ). Although there is significant variability in the prevalence of intestinal TB by geographic location and by the population’s risk profile, the true prevalence of the disease is difficult to ascertain, as many patients with pulmonary TB may be asymptomatic from their intestinal involvement ( ). This requires a very high index of suspicion, as a delay in diagnosis may result in detrimental outcomes. When patients do become symptomatic, their presentation may be nonspecific. Furthermore, as TB can involve any part of the gastrointestinal tract, the manifestations are protean ( ).

Citation: Choi E, Coyle W. 2017. Gastrointestinal Tuberculosis, p 411-432. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0014-2016
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Image of Figure 1
Figure 1

Endoscopic image of tuberculous involvement of the ileocecal valve and proximal colon. (Courtesy of Si Young Song, Yonsei University School of Medicine, Seoul, South Korea.)

Citation: Choi E, Coyle W. 2017. Gastrointestinal Tuberculosis, p 411-432. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0014-2016
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Image of Figure 2
Figure 2

Endoscopic image of a patulous ileocecal valve with a classic, fish mouth deformity and an ascending colon with mucosal erythema and nodularity secondary to TB. (Courtesy of Si Young Song, Yonsei University School of Medicine, Seoul, South Korea.)

Citation: Choi E, Coyle W. 2017. Gastrointestinal Tuberculosis, p 411-432. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0014-2016
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Image of Figure 3
Figure 3

Colonoscopic image of pseudopolyposis and stenosis from TB involvement of the transverse colon. (Courtesy of Si Young Song, Yonsei University School of Medicine, Seoul, South Korea.)

Citation: Choi E, Coyle W. 2017. Gastrointestinal Tuberculosis, p 411-432. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0014-2016
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Image of Figure 4
Figure 4

CT scan demonstrating segmental and circumferential wall thickening of the proximal colon due to TB involvement. (Courtesy of Si Young Song, Yonsei University School of Medicine, Seoul, South Korea.)

Citation: Choi E, Coyle W. 2017. Gastrointestinal Tuberculosis, p 411-432. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0014-2016
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