Significance of Colonscopy in the Early Diagnosis of Intestinal Tuberculosis

Hwang, Kie Eun; Jang, Nam Soo; Park, Chang Young; Lym, Si Young; Kim, Byung Ik; Jeon, Woo Kyu; Jung, Eul Soon; Lee, Sang Jong

Abstract

BACKGROUND/AIMS: Tuberculosis is a well-known disease as manifested by multi-organ involve- ment. Although the incidence of tuberculosis has reduced recently because of the advance of anti-tuberculosis chemotherapy, improvement of public health, and early diagnosis, it is still higher in developing countries. However, intestinal tuberculosis escapes early diagnosis due to its infrequency, vague manifestation, and difficulty in confirming the disease process. The advent of flexible colonoscopy has provided an opportunity to confirm the diagnosis of intestinal tuberculosis but the biopsy results were frequently false negative. Another difficulty encountered in confirming the diagnosis of intestinal tuberculosis by endoscopy was the frequent failure to Mycobacterium culture from tissue. Therefore, we examined histopathologic feature, acid-fast stain, and Mycobacterium culture with tissue section obtained by co]onoscopy at the same time.
METHODS
We studied and analyzed 118 cases of intestinal tuberculosis that was suspected by clinica] features and colonoscopic gross findings from January 1, 1991 to December 31,1995. All cases used an acid-fast stain with a tissue section obtained by colonoscopy.
RESULTS
We found 37 cases of caseous necrosis or granuloma (42%) and found 58 cases of AFB stain positivity (60%), and 12 cases of Mycobacterium culture positivity (14%) in 93 cases of intestinal tuberculosis.
CONCLUSIONS
This study suggests that early diagnosis of intestinal tuberculosis will be much improved by histopathologic feature, tissue AFB stain obtained by colonoscopic tissue biopsy.