Current Gastroenterology Reports

, Volume 5, Issue 4, pp 273–278 | Cite as

Gastrointestinal tuberculosis

  • Todd A. Sheer
  • Walter J. Coyle


Gastrointestinal tuberculosis is defined as infection of the peritoneum, hollow or solid abdominal organs, and abdominal lymphatics with Mycobacterium tuberculosis organisms. Gastrointestinal tuberculosis is relatively rare in the United States and is the sixth most common extrapulmonary location. Populations at risk include immigrants to the United States, the homeless, prisoners, residents of long-term care facilities, and the immunocompromised. The peritoneum and the ileocecal region are the most likely sites of infection and are involved in the majority of cases by hematogenous spread or through swallowing of infected sputum from primary pulmonary tuberculosis. Pulmonary tuberculosis is apparent in less than half of patients. Patients usually present with abdominal pain, weight loss, fever, anorexia, change in bowel habits, nausea, and vomiting. The diagnosis is often delayed and is usually made through a combination of radiologic, endoscopic, microbiologic, histologic, and molecular techniques. Antimicrobial treatment is the same as for pulmonary tuberculosis. Surgery is occasionally required.


Tuberculosis Infliximab Pulmonary Tuberculosis Directly Observe Therapy Abdominal Tuberculosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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References and Recommended Reading

  1. 1.
    CDC Surveillance Reports: Reported tuberculosis in the United States, 2001. http:/ surv2001/default.htm. Accessed December 1, 2002.Google Scholar
  2. 2.
    Marshall JB: Tuberculosis of the gastrointestinal tract and peritoneum. Am J Gastroenterol 1993, 88:989–997.PubMedGoogle Scholar
  3. 3.
    Segal I, Ou Tim L, Mirwis J, et al.: Pitfalls in the diagnosis of gastrointestinal tuberculosis. Am J Gastroenterol 1981, 75:30–35.PubMedGoogle Scholar
  4. 4.
    Nzarubara GR: Gastro-intestinal tuberculosis: an emerging diagnostic dilemma. East Afr Med J 1998, 75:124–126.PubMedGoogle Scholar
  5. 5.
    McGee GS, Williams LF, Potts J, et al.: Gastrointestinal tuberculosis: resurgence of an old pathogen. Am Surg 1989, 55:16–20.PubMedGoogle Scholar
  6. 6.
    Dineen P, Homan WP, Grafe WR: Tuberculous peritonitis: 43 years’ experience in diagnosis and treatment. Ann Surg 1976, 184:717–722.CrossRefGoogle Scholar
  7. 7.
    Horvath KD, Whelan RL: Intestinal tuberculosis: return of an old disease. Am J Gastroenterol 1998, 93:692–696. A concise yet thorough review of enteric tuberculosis.PubMedCrossRefGoogle Scholar
  8. 8.
    Naga MI, Okasha HH, Ismail Z, et al.: Endoscopic diagnosis of colonic tuberculosis. Gastrointest Endosc 2001, 53:789–793. Endoscopic review of 10 patients with colonic tuberculosis with excellent images highlighting the classic findings.PubMedCrossRefGoogle Scholar
  9. 9.
    Klimach OE, Ormerod LP: Gastrointestinal tuberculosis: a retrospective review of 109 cases in a district general hospital. Q J Med 1985, 56:569–578.PubMedGoogle Scholar
  10. 10.
    Walia HS, Khafagy AR, Al-Sayer HM, et al.: Unusual presentations of abdominal tuberculosis. Can J Surg 1994, 37:300–306.PubMedGoogle Scholar
  11. 11.
    Nair KV, Pai CG, Rajagopal KP, et al.: Unusual presentations of duodenal tuberculosis. Am J Gastroenterol 1991, 86:756–760.PubMedGoogle Scholar
  12. 12.
    Porter KA, Henson J, Chong FK: Perforated gastrointestinal tuberculosis [letter]. Dig Dis Sci 1990, 35:1046–1048.PubMedCrossRefGoogle Scholar
  13. 13.
    Scully RE, Mark EJ, McNeely WF, et al.: Case records of the Massachusetts General Hospital. N Engl J Med 1991, 325:1295–1302.CrossRefGoogle Scholar
  14. 14.
    Chaisson RE, Schecter GF, Theuer CP, et al.: Tuberculosis in patients with the acquired immunodeficiency syndrome: clinical features, response to therapy, and survival. Am Rev Respir Dis 1987, 136:570–574.PubMedGoogle Scholar
  15. 15.
    Brizi MG, Celi G, Scaldazza AV, et al.: Diagnostic imaging of abdominal tuberculosis: gastrointestinal tract, peritoneum, lymph nodes. Rays 1998, 23:115–125.PubMedGoogle Scholar
  16. 16.
    Sherman S, Rohwedder JJ, Ravikrishnan KP, et al.: Tuberculous enteritis and peritonitis. Arch Intern Med 1980, 140:506–508.PubMedCrossRefGoogle Scholar
  17. 17.
    Bernhard JS, Bhatia G, Knauer CM: Gastrointestinal tuberculosis: an eighteen-patient experience and review. J Clin Gastroenterol 2000, 30:397–402.PubMedCrossRefGoogle Scholar
  18. 18.
    Al Karawi MA, Mohamed AE, Yasawy MI, et al.: Protean manifestations of gastrointestinal tuberculosis: report on 130 cases. J Clin Gastroenterol 1995, 20:225–232.CrossRefGoogle Scholar
  19. 19.
    Lundstedt C, Nyman R, Brismar J, et al.: Imaging of tuberculosis. Acta Radiol 1996, 37:489–495.PubMedCrossRefGoogle Scholar
  20. 20.
    Pettengell KE, Larsen C, Garb M, et al.: Gastrointestinal tuberculosis in patients with pulmonary tuberculosis. Q J Med 1990, 74:303–308.PubMedGoogle Scholar
  21. 21.
    Mitchel RS: The prognosis of bilateral symmetrical diffuse nodular pulmonary tuberculosis and its possible relation to intestinal tuberculosis. Dis Chest 1956, 29:669–674.Google Scholar
  22. 22.
    Al Muneef M, Memish Z, Al Mahmoud S, et al.: Tuberculosis in the belly: a review of forty-six cases involving the gastrointestinal tract and peritoneum. Scand J Gastroenterol 2001, 36:528–532. Well-organized collection of 46 cases of abdominal tuberculosis accrued over 11 years that provides a good synopsis of the presentations and laboratory, radiologic, and microbiologic findings.Google Scholar
  23. 23.
    Burack WR, Hollister RM: Tuberculous peritonitis: a study of forty-seven proved cases encountered by a general medical unit in twenty-five years. Am J Med 1960, 28:510–523.PubMedCrossRefGoogle Scholar
  24. 24.
    Alatas F, Ozdemir N, Isiksoy S, et al.: An unusual case of esophageal tuberculosis in an adult. Respiration 1999, 66:88–90.PubMedCrossRefGoogle Scholar
  25. 25.
    Fan ST, Yan KW, Lau WY, et al.: Tuberculosis of the pancreas: a rare cause of massive gastrointestinal bleeding. Br J Surg 1986, 73:373.PubMedCrossRefGoogle Scholar
  26. 26.
    Dock W, Grabenwoger F, Bardach G, et al.: An unusual case of hemobilia. Br J Radiol 1987, 60:1228–1229.PubMedCrossRefGoogle Scholar
  27. 27.
    Sheen-Chen SM, Chou FF, Tai DI, et al.: Hepatic tuberculosis; a rare cause of bleeding gastric varices. Tubercle 1990, 71:225–227.PubMedCrossRefGoogle Scholar
  28. 28.
    Weissman D, Gumaste VV, Dave PB, et al.: Bleeding from a tuberculous gastric ulcer. Am J Gastroenterol 1990, 85:742–744.PubMedGoogle Scholar
  29. 29.
    Vijayraghavan M, Arunabh, Sarda AK, et al.: Duodenal tuberculosis: a review of the clinicopathologic features and management of twelve cases. Jpn J Surg 1990, 20:526–529.PubMedCrossRefGoogle Scholar
  30. 30.
    Catinella FP, Kittle CF: Tuberculosis esophagitis with aortic aneurysm fistula. Ann Thorac Surg 1988, 45:87–88.PubMedCrossRefGoogle Scholar
  31. 31.
    Goldbaum TS, Lindsay J, Levy C, et al.: Tuberculous aortitis presenting with an aortoduodenal fistula: a case report. Angiology 1986, 37:519–523.PubMedGoogle Scholar
  32. 32.
    Panton ON, Sharp R, English RA, et al.: Gastrointestinal tuberculosis: the great mimic still at large. Dis Colon Rectum 1985, 28:446–450.PubMedCrossRefGoogle Scholar
  33. 33.
    Keane J, Gershon S, Wise RP, et al.: Tuberculosis associated with infliximab, a tumor necrosis factor _-neutralizing agent. N Engl J Med 2001, 345:1098–1104. Analysis of all cases of tuberculosis after treatment with infliximab reported to the US Food and Drug Administration as of May 2001. Recommends that all patients with latent tuberculosis be given prophylactic treatment prior to administration of infliximab.PubMedCrossRefGoogle Scholar
  34. 34.
    Das P, Shukla HS: Clinical diagnosis of abdominal tuberculosis. Br J Surg 1976, 63:941–946.PubMedCrossRefGoogle Scholar
  35. 35.
    Akhan O, Pringot J: Imaging of abdominal tuberculosis. Eur Radiol 2002, 12:312–323. Highly detailed review of the findings on barium, ultrasound, and CT imaging in abdominal tuberculosis with a discussion of the differential diagnosis such findings generate.PubMedCrossRefGoogle Scholar
  36. 36.
    Hulnick DH, Megibow AJ, Naidich DP, et al.: Abdominal tuberculosis: CT evaluation. Radiology 1985, 157:199–204.PubMedGoogle Scholar
  37. 37.
    Leung VK, Tang WL, Cheung CH, et al.: Importance of ileoscopy during colonoscopy for the early diagnosis of ileal tuberculosis: report of two cases. Gastrointest Endosc 2001, 53:813–815.PubMedCrossRefGoogle Scholar
  38. 38.
    Franklin GO, Mohapatra M, Perillo RP: Colonic tuberculosis diagnosed by colonoscopic biopsy. Gastroenterology 1979, 76:362–364.PubMedGoogle Scholar
  39. 39.
    Aoki G, Nagasaki K, Nakae Y: The fibercolonoscopic diagnosis of intestinal tuberculosis. Endoscopy 1971, 7:113–118.Google Scholar
  40. 40.
    Breiter JR, Hajjar J: Segmental tuberculosis of the colon diagnosed by colonoscopy. Am J Gastroenterol 1981, 76:369–373.PubMedGoogle Scholar
  41. 41.
    Shah S, Thomas V, Mathan M, et al.: Colonoscopic study of 50 patients with colonic tuberculosis. Gut 1992, 33:347–351.PubMedGoogle Scholar
  42. 42.
    Bhargava DK, Kushwaha AK, Dasarathy S, et al.: Endoscopic diagnosis of segmental colonic tuberculosis. Gastrointest Endosc 1992, 38:571–574.PubMedGoogle Scholar
  43. 43.
    Bhargava DK, Tandon HD, Chawla TC, et al.: Diagnosis of ileocecal and colonic tuberculosis by colonoscopy. Gastrointest Endosc 1985, 31:68–70.PubMedCrossRefGoogle Scholar
  44. 44.
    Singh V, Kumar P, Kamal J, et al.: Clinicocolonoscopic profile of colonic tuberculosis. Am J Gastroenterol 1996, 91:565–568.PubMedGoogle Scholar
  45. 45.
    Anand BS, Schneider FE, El-Zaatari FA, et al.: Diagnosis of intestinal tuberculosis by polymerase chain reaction on endoscopic biopsy specimens. Am J Gastroenterol 1994, 89:2248–2249.PubMedGoogle Scholar
  46. 46.
    Gan HT, Chen YQ, Ouyang Q, et al.: Differentiation between intestinal tuberculosis and Crohn’s disease in endoscopic biopsy specimens by polymerase chain reaction. Am J Gastroenterol 2002, 97:1446–1451.PubMedCrossRefGoogle Scholar
  47. 47.
    Moatter T, Mirza S, Siddiqui MS, et al.: Detection of Mycobacterium tuberculosis in paraffin embedded intestinal tissue specimen by polymerase chain reaction: characterization of IS6110 element negative strains. J Pak Med Assoc 1998, 48:174–178.PubMedGoogle Scholar
  48. 48.
    Gan H, Ouyang Q, Bu H: The value of polymerase chain reaction assay in the diagnosis of intestinal tuberculosis and differentiation from Crohn’s disease. Chin J Intern Med 1995, 34:30–33.Google Scholar
  49. 49.
    Kashima K, Oka S, Tabata A, et al.: Detection of anti-cord factor antibodies in intestinal tuberculosis for its differential diagnosis from Crohn’s disease and ulcerative colitis. Dig Dis Sci 1995, 40:2630–2634.PubMedCrossRefGoogle Scholar
  50. 50.
    American Thoracic Society: Treatment of tuberculosis and tuberculosis infection in adults and children. Am J Respir Crit Care Med 1994, 149:1359–1374.Google Scholar

Copyright information

© Current Science Inc 2003

Authors and Affiliations

  • Todd A. Sheer
    • 1
  • Walter J. Coyle
    • 1
  1. 1.Department of GastroenterologyNaval Medical Center San DiegoSan DiegoUSA

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