A Case of Intestinal Tuberculosis with Perianal Fistula Diagnosed after 30 Years.
10.4166/kjg.2013.62.6.370
- Author:
Ji Hyun CHEON
1
;
Won MOON
;
Seun Ja PARK
;
Moo In PARK
;
Sung Eun KIM
;
Youn Jung CHOI
;
Jong Bin KIM
;
Hye Jung KWON
Author Information
1. Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea. moonone70@hanmail.net
- Publication Type:Case Reports ; English Abstract
- Keywords:
Gastrointestinal tuberculosis;
Crohn disease;
Anal fistula
- MeSH:
Anal Canal;
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use;
Antitubercular Agents/therapeutic use;
Colon/pathology;
Colonoscopy;
Crohn Disease/diagnosis/drug therapy;
Diagnosis, Differential;
Fistula/*diagnosis/pathology;
Humans;
Ileocecal Valve/physiopathology;
Male;
Mesalamine/therapeutic use;
Middle Aged;
Protein C/analysis;
Tuberculosis, Gastrointestinal/*diagnosis/drug therapy
- From:The Korean Journal of Gastroenterology
2013;62(6):370-374
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Tuberculosis can occur anywhere in the gastrointestinal tract. However, anorectal tuberculosis has rarely been reported. A 46-years-old male presented with abdominal pain and perianal discharge of 30 years' duration. The patient had received operations for anal fistula and inflammation three times. Although he had been taking mesalazine for the past three years after being diagnosed with Crohn's disease, his symptoms persisted. Colonoscopy performed at our hospital revealed cicatricial change of ileocecal valve and diffuse ulcer scar with mild luminal narrowing of the ascending, transverse, and descending colon without active lesions. Multiple large irregular active ulcers were observed in the distal sigmoid and proximal rectum. An anal fistula opening with much yellowish discharge and background ulcer scar was observed in the anal canal. However, cobble-stone appearance and pseudopolyposis were not present. Therefore, we clinically diagnosed him as having intestinal tuberculosis with anal fistula and prescribed antituberculosis medications. Follow-up colonoscopy performed 3 months later showed much improved multiple large irregular ulcers in the distal sigmoid colon and proximal rectum along with completely resolved anal fistula without evidence of pus discharge.
