Intestinal and Peritoneal Tuberculosis: A Clinical Study of Five Recent Years (1989-1994)

Liu, Sun Kyung; Kim, Jin Cheon; Kim, Hae Ryeon; Kim, Woo Sung; Kim, Suk Ku

Abstract

BACKGROUND/AIMS: We must consider intestinal and peritoneal tuberculosis among differential diagnosis of inflammatory bowel disease regardless of pulmonary tuberculosis, The purpose of this study is to characterize the clinical feature of intestinal and peritoneal tuberculsis at the time of decreasing pulmonary tuberculosis.
METHODS
From June 1989 to December 1994, 130 cases of intestinal and peritoneal tuberculosis were diagnosed at the Asan Medical Center. Chest X-ray, colon study, colonofiberscopy, peritoneoscopy, and biopsy were used as diagnostic tools.
RESULTS
The sex ratio was 1:1.4 in favor of females. The peak incidence was among the fourth decade. Chief complaints were abdominal pain in the half of the cases, followed by abdominal distension, diarrhea, abdominal discomfort, abdominal rnass, and indigestion in descending order. The average symptom duration lasted 4.1 months. Fifty-seven percent of the patients had synchronous pulmonary tuberculosis. The sensitivity of barium enema and colonofiberscopy were 84.3% and 89.8% respectively. The ileocecal area was the most frequent location, and then ascending colon, sigmoid colon, transverse colon, rectum, jejunum, and descending colon in descending order. Thirty-two of the patients(23.9%) had an operation. The ileocecal lesion was prone to need surgical intervention than other lesions(P<0.0001). Surgery of intestinal and peritoneal tuberculosis did not affect comp]ication rate.
CONCLUSIONS
We must consider intestinal or peritoneal tuberculosis in patients with atypical abdominal symptoms because intestinal and peritoneal tuberculosis is frequently met with the decrement of pulmonary tuberculosis. The colonofiberscopy was the most efficient diagnostic tool. Medical treatment must precede surgery and surgical intervention is used as indicated to treat complications.